Bryant Courtney, Mayhew Mackenzie, Fleites Jorge, Lozano Juan, Saunders John M
Pediatric Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.
Translational Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.
Cureus. 2020 Nov 30;12(11):e11797. doi: 10.7759/cureus.11797.
Introduction Despite improvements in the prognosis of acute lymphoblastic leukemia (ALL), it is still the most common childhood cancer. The goal of this study was to investigate if there was a significant difference in the five-year survival between Black and White children with ALL, specifically up to the year 2016 which has not been researched. Methods A retrospective cohort study of Black and White children diagnosed with ALL between 1975 and 2016 was carried out using the Surveillance, Epidemiology, and End Results (SEER) Program database. Children aged 0-19 were separated into Black or White, and then survival analysis was used to compare five-year survival. A multivariate cox regression analysis was carried out to determine the association between race and five-year survival with ALL. Results Our sample included 17,663 cases consisting of 16,238 White children and 1,425 Black children. White children had a significantly increased five-year mortality survival when compared to Black children. Upon using multivariate cox regression analysis, both unadjusted and adjusted models showed a significantly higher risk of death in Black children when compared to White children. Conclusions Our study found that there is a significant difference in the five-year survival between Black and White children diagnosed with ALL. The difference in survival persists even when controlling for sex, age at diagnosis, year of diagnosis, and histology. Future studies should be carried out to control for more confounders that the SEER database is unable to control for.
引言 尽管急性淋巴细胞白血病（ALL）的预后有所改善，但它仍是最常见的儿童癌症。本研究的目的是调查患有ALL的黑人儿童和白人儿童在五年生存率上是否存在显著差异，特别是截至2016年这一尚未被研究的时间段。方法 使用监测、流行病学和最终结果（SEER）计划数据库，对1975年至2016年间被诊断为ALL的黑人儿童和白人儿童进行回顾性队列研究。将0至19岁的儿童分为黑人或白人，然后使用生存分析来比较五年生存率。进行多变量cox回归分析以确定种族与ALL五年生存率之间的关联。结果 我们的样本包括17,663例病例，其中有16,238名白人儿童和1,425名黑人儿童。与黑人儿童相比，白人儿童的五年死亡率生存率显著增加。在使用多变量cox回归分析时，未调整和调整后的模型均显示，与白人儿童相比，黑人儿童的死亡风险显著更高。结论 我们的研究发现，被诊断为ALL的黑人儿童和白人儿童在五年生存率上存在显著差异。即使在控制了性别、诊断时年龄、诊断年份和组织学等因素后，生存差异仍然存在。未来应开展更多研究，以控制SEER数据库无法控制的更多混杂因素。
