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Young age at diagnosis is a risk factor for negative late socio‐economic effects after acute lymphoblastic leukemia in childhood
Author(s) -
Holmqvist Anna Sällfors,
Wiebe Thomas,
Hjorth Lars,
Lindgren Anna,
Øra Ingrid,
Moëll Christian
Publication year - 2010
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22670
Subject(s) - medicine , marital status , risk factor , pediatrics , demography , young adult , population , cancer , socioeconomic status , lymphoblastic leukemia , childhood cancer , leukemia , gerontology , environmental health , sociology
Background The increasing number of survivors after childhood cancer requires characterization of the late complications of these diseases and their treatment. We examined a large number of possible socio‐economic late effects following treatment for acute lymphoblastic leukemia (ALL) in order to identify factors leading to a poor outcome. Procedure All individuals who had been diagnosed with ALL and who were alive in January 2007 (n = 213; men = 107) were identified from a database of all patients with cancer before the age of 18 in Southern Sweden from 1970 to 1999. For each subject, 50 matched controls were identified from the Swedish Population Register. Information on marital status, children, education, employment, income, and support from the community was obtained from Statistics Sweden. Results At the ages of 25 and 30, survivors of ALL had attained a lower level of education than controls. At the age of 30, they were less often employed (70% vs. 82%, P = 0.019), less often married (19% vs. 32%, P = 0.019), and had children to a lesser extent (31% vs. 47%, P = 0.011) than controls. We identified young age at diagnosis as a risk factor for adverse outcome in the majority of the socio‐economic variables studied, apart from the known risk of cranial irradiation treatment. Furthermore, female survivors had a greater risk of achieving a lower level of education than both male survivors and controls. Conclusions Young age at diagnosis, as well as treatment with cranial irradiation, is a risk factor for socio‐economic late effects after treatment for ALL in childhood. Pediatr Blood Cancer. 2010;55:698–707. © 2010 Wiley‐Liss, Inc.