Amir Almasi-Hashiani, Soheil Zareifar, Mehran Karimi, Esmaeil Khedmati, Abolfazl Mohammadbeigi
Department of Public Health, School of Health, Arak University of Medical Sciences, Arak, Iran.
Iran J Pediatr. 2013 Feb;23(1):53-8.
Leukemia is the most prevalent type of cancer in children. The aim of this study was to estimate the 5-year survival rates of Acute Lymphoblastic Leukemia (ALL) and Acute Myeloblastic Leukemia (AML) as well as factors influencing them.
This is a nonrandomized retrospective study conducted on 280 patients with ALL and AML. They were all below 15 years old children admitted to Shahid Faghihi hospital, Shiraz, Iran from 2004 to 2008.The survival rates were estimated by applying the Kaplan-Meier method. In addition, the log rank test was used to estimate the statistical significance of differences in the survival probability. Cox regression model was applied to conduct multivariate analysis for adjusting confounding variable. All analyses were performed in SPSS statistical software (version 16). P-values less than 0.05 were considered as statistically significant.
The mean (± standard deviation) of the observation period was 28.2±16.1 months. In this period, 60 (24.7%) patients (47 ALL and 15 AML) passed away. The cumulative rate of survival in this study was 53.3±0.1 percent. This probability was 56.6±0.1% and 44.2±0.1% for ALL and AML patients, respectively, which indicates no statistically significant difference between them (P=0.8). According to Cox model, there was a significant relationship among the variables of platelet count and relapse with the survival rate.
Platelet count was identified as a positive prognostic factor of the survival rate in ALL patients. However, on the base of our results and other studies, incidence of relapse and the number of relapses are significant factors of survival rates of leukemia.
白血病是儿童中最常见的癌症类型。本研究的目的是估计急性淋巴细胞白血病（ALL）和急性髓细胞白血病（AML）的5年生存率以及影响它们的因素。
这是一项对280例ALL和AML患者进行的非随机回顾性研究。他们均为2004年至2008年入住伊朗设拉子沙希德·法吉希医院的15岁以下儿童。生存率采用Kaplan-Meier方法进行估计。此外，对数秩检验用于估计生存概率差异的统计学显著性。采用Cox回归模型进行多变量分析以调整混杂变量。所有分析均在SPSS统计软件（版本16）中进行。P值小于0.05被认为具有统计学显著性。
观察期的平均（±标准差）为28.2±16.1个月。在此期间，60例（24.7%）患者（47例ALL和15例AML）死亡。本研究中的累积生存率为53.3±0.1%。ALL和AML患者的这一概率分别为56.6±0.1%和44.2±0.1%，表明两者之间无统计学显著差异（P = 0.8）。根据Cox模型，血小板计数和复发变量与生存率之间存在显著关系。
血小板计数被确定为ALL患者生存率的一个阳性预后因素。然而，根据我们的研究结果和其他研究，复发率和复发次数是白血病生存率的重要因素。
