Coebergh J W, van der Does-van den Berg A, Hop W C, van Weerden F, Rammeloo J A, van Steensel H A, van Wering E R, Kamps W A
Dutch Childhood Leukaemia Study Group, Hauge, Netherlands.
Eur J Cancer. 1996 Feb;32A(2):286-9. doi: 10.1016/0959-8049(95)00577-3.
We studied the effect of parental educational level (PEL), an indicator of socio-economic status (SES), on survival of children with acute lymphoblastic (ALL) and non-lymphoblastic leukaemia (ANLL). All children with ALL and ANLL diagnosed in The Netherlands in the period 1973-1979, registered by the Dutch Childhood Leukaemia Study Group and followed until 1991 were included. Bone marrow and blood smears had been uniformly classified in a central laboratory; cases with acute lymphoblastic leukaemia (ALL) were subdivided into standard risk (SR) and high risk (HR). PEL, assessed as a risk indicator in a separately conducted population-based case-control study of the same children (response rate: 88%), was divided into low, when neither of the parents had more than elementary school or lower vocational education, and high when either had more. Children with SR ALL of high PEL parents had a slightly higher 10-year survival rate than of low PEL parents (58% versus 54%, P = 0.25), whereas survival for the latter increased more (P = 0.06) from a lower level in the period 1973-1975. However, children of low PEL parents with HR ALL and ANLL had a higher 10-year survival rate compared with children of high PEL parents (P = 0.10 and 0.22, respectively). Children without information on PEL, non-responders, migrants and with missing values exhibited slightly worse survival rates. The influence of PEL on survival of acute leukaemia in children in The Netherlands during 1973-1979 appeared small or even equivocal. Small differences in SES and optimal geographic and financial access to care, delivered through national treatment protocols, may be responsible for these results.
我们研究了作为社会经济地位（SES）指标的父母教育水平（PEL）对急性淋巴细胞白血病（ALL）和非淋巴细胞白血病（ANLL）患儿生存情况的影响。纳入了1973年至1979年期间在荷兰被诊断为ALL和ANLL、由荷兰儿童白血病研究组登记并随访至1991年的所有患儿。骨髓和血液涂片已在中央实验室进行统一分类；急性淋巴细胞白血病（ALL）病例被细分为标准风险（SR）和高风险（HR）。在对同一批儿童单独进行的基于人群的病例对照研究中（应答率：88%），PEL被评估为一个风险指标，分为低水平（父母双方均未接受过小学以上教育或更低的职业教育）和高水平（父母任何一方接受过小学以上教育）。高PEL父母的SR ALL患儿的10年生存率略高于低PEL父母的患儿（58%对54%，P = 0.25），而在1973年至1975年期间，后者的生存率从较低水平上升幅度更大（P = 0.06）。然而，低PEL父母的HR ALL和ANLL患儿的10年生存率高于高PEL父母的患儿（分别为P = 0.10和0.22）。没有PEL信息、无应答者、移民以及有缺失值的患儿生存率略低。1973年至1979年期间，PEL对荷兰儿童急性白血病生存情况的影响似乎很小甚至不明确。SES的微小差异以及通过国家治疗方案提供的最佳地理和经济可及的医疗服务可能是导致这些结果的原因。
