Skip to main content

Advertisement

SpringerLink
Log in

Demographic and treatment risk factors of cancer-specific mortality among children and adolescent leukemia patients: a population-based study

  • Research Article
  • Published:
Environmental Science and Pollution Research Aims and scope Submit manuscript

Abstract

Leukemia is the 15th most commonly diagnosed cancer and the 11th leading cause of cancer mortality. The high mortality rate of leukemia could be attributed to numerous factors. Therefore, we aimed to identify the demographic and treatment risk factors influencing mortality among patients diagnosed with leukemia. Patients’ data from 1975 to 2016 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. We used the Person’s chi-square test to examine the associations among the categorical variables. Kaplan–Meier and Cox regression were applied for univariate and multivariate analyses. Standardized mortality ratios were utilized to compare the mortality rates of leukemia patients and the general US population. We carried out the statistical analysis using SPSS software. A total of 18,880 patients with leukemia were studied. The leukemia incidence was increased in children than in adolescents. Acute lymphoid leukemia (ALL) was the most common type diagnosed among children and adolescents: 10,331 and 4112 patients, respectively. All mortality ratios were significantly higher in leukemia patients compared to the US population. The risk of mortality among leukemia patients was higher among adolescents, females, Black, urban areas with a 20,000 population, and patients not receiving chemotherapy. In contrast, the mortality risk was decreased in patients with higher family incomes, those not treated with radiation, and diagnosed from 2000 to 2016. In conclusion, Leukemia’s incidence increases with time. Adolescents, males, Black, in some urban areas, and patients who have not received chemotherapy had the highest mortality risk among leukemia patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

The datasets generated and/or analyzed during the current study are available in the SEER database. https://seer.cancer.gov/

References

  • Belson M, Kingsley B, Holmes A (2007) Risk factors for acute leukemia in children: a review. Environ Health Perspect 115:138–145

    Article  CAS  Google Scholar 

  • Beltrami A, Hilliard A, Green AL (2022) Demographic and socioeconomic disparities in pediatric cancer in the United States: Current knowledge, deepening understanding, and expanding intervention. Cancer Epidemiol 76:102082

    Article  Google Scholar 

  • Boice JD Jr, Miller RW (1999) Childhood and adult cancer after intrauterine exposure to ionizing radiation. Teratology 59:227–233

    Article  CAS  Google Scholar 

  • Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: Cancer J Clin 68:394–424

  • Brayley J, Stanton LK, Jenner L, Paul SP (2019) Recognition and management of leukaemia in children. Br J Nurs 28:985–992

    Article  Google Scholar 

  • Campo E, Swerdlow SH, Harris NL, Pileri S, Stein H, Jaffe ES (2011) The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood 117:5019–5032

    Article  CAS  Google Scholar 

  • Castellanos MI, Dongarwar D, Wanser R, Caceres I, Park C, Rodriguez J, Salihu HM (2022) In-hospital Mortality and Racial Disparity in Children and Adolescents With Acute Myeloid Leukemia: A Population-based Study. J Pediatr Hematol/Oncol 44

  • Clarke RT, Van Den Bruel A, Bankhead C, Mitchell CD, Phillips B, Thompson MJ (2016) Clinical presentation of childhood leukaemia: a systematic review and meta-analysis. Arch Dis Child 101:894–901

    Article  Google Scholar 

  • Dores GM, Devesa SS, Curtis RE, Linet MS, Morton LM (2012) Acute leukemia incidence and patient survival among children and adults in the United States, 2001–2007. Blood 119:34–43

    Article  CAS  Google Scholar 

  • Holmes L Jr, Williams MA, Halloran DR, Benson JA, Bafford NT, Parson KV, Dabney K, Berice BN (2021) Social gradient predicts survival disadvantage of African Americans/Black children with lymphoma. J Natl Med Assoc 113:414–427

    Google Scholar 

  • Hossain MJ, Xie L, Mccahan SM (2014) Characterization of Pediatric Acute Lymphoblastic Leukemia Survival Patterns by Age at Diagnosis. J Cancer Epidemiol 2014:865979

    Article  Google Scholar 

  • Howlader NNA, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds) (2019) SEER Cancer Statistics Review, 1975-2017, National Cancer Institute. Bethesda, MD. https://seer.cancer.gov/csr/1975_2017/, based on November 2019 SEER data submission, posted to the SEER web site, April 2020

  • Inclan-Alarcon SI, Riviello-Goya S, Teran-De-la-Sancha K, Fierro-Angulo OM, Acosta-Medina AA, Demichelis-Gomez R, Bourlon C (2022) Induction-related mortality in adolescents and young adults with acute lymphoblastic leukemia in a resource-limited setting: do treatment-related complications create more impact than disease biology? Blood Res. 57(1):29–33. https://doi.org/10.5045/br.2021.2021058

    Article  CAS  Google Scholar 

  • Ji BT, Shu XO, Linet MS, Zheng W, Wacholder S, Gao YT, Ying DM, Jin F (1997) Paternal cigarette smoking and the risk of childhood cancer among offspring of nonsmoking mothers. J Natl Cancer Inst 89:238–244

    Article  CAS  Google Scholar 

  • Jin MW, Xu SM, An Q, Wang P (2016) A review of risk factors for childhood leukemia. Eur Rev Med Pharmacol Sci 20:3760–3764

    Google Scholar 

  • Juliusson G, Hough R (2016) Leukemia. Prog. Tumor Res 43:87–100

    Article  Google Scholar 

  • Kahn JM, Pei Q, Friedman DL, Kaplan J, Keller FG, Hodgson D, Wu Y, Appel BE, Bhatia S, Henderson TO, Schwartz CL, Kelly KM, Castellino SM (2022) Survival by age in paediatric and adolescent patients with Hodgkin lymphoma: a retrospective pooled analysis of children’s oncology group trials. Lancet Haematol 9:e49–e57

    Article  CAS  Google Scholar 

  • Kantarjian H, Thomas D, Obrien S, Cortes J, Giles F, Jeha S, Bueso-Ramos CE, Pierce S, Shan J, Koller C, Beran M, Keating M, Freireich EJ (2004) Long-term follow-up results of hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (Hyper-CVAD), a dose-intensive regimen, in adult acute lymphocytic leukemia. Cancer 101:2788–2801

    Article  CAS  Google Scholar 

  • Kommalapati A, Tella SH, Ganti AK, Armitage JO (2018) Natural Killer/T-cell Neoplasms: Analysis of Incidence, Patient Characteristics, and Survival Outcomes in the United States. Clin Lymphoma Myeloma Leuk 18:475–479

    Article  Google Scholar 

  • Larson RA, Dodge RK, Burns CP, Lee EJ, Stone RM, Schulman P, Duggan D, Davey FR, Sobol RE, Frankel SR (1995) A five-drug remission induction regimen with intensive consolidation for adults with acute lymphoblastic leukemia: cancer and leukemia group B study 8811. Blood 85:2025–2037

    Article  CAS  Google Scholar 

  • Ma X, Buffler PA, Gunier RB, Dahl G, Smith MT, Reinier K, Reynolds P (2002) Critical windows of exposure to household pesticides and risk of childhood leukemia. Environ Health Perspect 110:955–960

    Article  CAS  Google Scholar 

  • Maury S, Chevret S, Thomas X, Heim D, Leguay T, Huguet F, Chevallier P, Hunault M, Boissel N, Escoffre-Barbe M, Hess U, Vey N, Pignon J-M, Braun T, Marolleau J-P, Cahn J-Y, Chalandon Y, Lhéritier V, Beldjord K, Béné MC, Ifrah N, Dombret H (2016) Rituximab in B-Lineage Adult Acute Lymphoblastic Leukemia. N Engl J Med 375:1044–1053

    Article  CAS  Google Scholar 

  • McNally RJ, Parker L (2006) Environmental factors and childhood acute leukemias and lymphomas. Leuk Lymphoma 47:583–598

    Article  Google Scholar 

  • Miranda-Filho A, Piñeros M, Ferlay J, Soerjomataram I, Monnereau A, Bray F (2018) Epidemiological patterns of leukaemia in 184 countries: a population-based study. Lancet Haematol 5:e14–e24

    Article  Google Scholar 

  • Mittal N, Davidson J, Martinez MF, Sanchez R, Sane N, Giordano L, Choi DK, Kent P, Dighe D, Iqbal A, Kiely C, Breen K, Quigley JG, Catchatourian R, Gitelis S, Schmidt ML (2019) A Tri-Institutional Approach to Address Disparities in Children’s Oncology Group Clinical Trial Accrual for Adolescents and Young Adults and Underrepresented Minorities. J Adolesc Young Adult Oncol 8:227–235

    Article  Google Scholar 

  • Mogensen H, Modig K, Tettamanti G, Talbäck M, Feychting M (2016) Socioeconomic differences in cancer survival among Swedish children. Br J Cancer 114:118–124

    Article  Google Scholar 

  • Noonan AS, Velasco-Mondragon HE, Wagner FA (2016) Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public Health Rev. 37:12. https://doi.org/10.1186/s40985-016-0025-4

    Article  Google Scholar 

  • Petridou ET, Sergentanis TN, Perlepe C, Papathoma P, Tsilimidos G, Kontogeorgi E, Kourti M, Baka M, Moschovi M, Polychronopoulou S, Sidi V, Hatzipantelis E, Stiakaki E, Iliadou AN, La Vecchia C, Skalkidou A, Adami HO (2015) Socioeconomic disparities in survival from childhood leukemia in the United States and globally: a meta-analysis. Ann Oncol 26:589–597

    Article  CAS  Google Scholar 

  • Rodriguez-Abreu D, Bordoni A, Zucca E (2007) Epidemiology of hematological malignancies. Ann Oncol 18(Suppl 1):i3–i8

    Article  Google Scholar 

  • Ross JA, Davies SM, Potter JD, Robison LL (1994) Epidemiology of childhood leukemia, with a focus on infants. Epidemiol Rev 16:243–272

    Article  CAS  Google Scholar 

  • Scheurer ME, Lupo PJ, Schüz J, Spector LG, Wiemels JL, Aplenc R, Gramatges MM, Schiffman JD, Pombo-De-Oliveira MS, Yang JJ, Heck JE, Metayer C, Orjuela-Grimm MA, Bona K, Aristizabal P, Austin MT, Rabin KR, Russell HV, Poplack DG (2018) An overview of disparities in childhood cancer: Report on the Inaugural Symposium on Childhood Cancer Health Disparities, Houston, Texas, 2016. Pediatr Hematol Oncol 35:95–110

    Article  Google Scholar 

  • Suzuki R, Suzumiya J, Yamaguchi M, Nakamura S, Kameoka J, Kojima H, Abe M, Kinoshita T, Yoshino T, Iwatsuki K, Kagami Y, Tsuzuki T, Kurokawa M, Ito K, Kawa K, Oshimi K (2010) Prognostic factors for mature natural killer (NK) cell neoplasms: aggressive NK cell leukemia and extranodal NK cell lymphoma, nasal type. Ann Oncol 21:1032–1040

    Article  CAS  Google Scholar 

  • Vickers M, Jackson G, Taylor P (2000) The incidence of acute promyelocytic leukemia appears constant over most of a human lifespan, implying only one rate limiting mutation. Leukemia 14:722–726

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This research was supported by Princess Nourah bint Abdulrahman University Researchers Supporting Project number (PNURSP2022R30), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.

Funding

This research was supported by Princess Nourah bint Abdulrahman University Researchers Supporting Project number (PNURSP2022R30), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.

Author information

Authors and Affiliations

  1. Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Alaa Ahmed Elshanbary

  2. Department of Pediatrics, King Salman Hospital, Riyadh, Saudi Arabia

    Ayat Hassan Zilai

  3. Faculty of Medicine, The Hashemite University, Zarqa, Jordan

    Anas Ishqair

  4. Faculty of Pharmacy, University of Jordan, Amman, Jordan

    Sajeda Ghassan Matar

  5. Faculty of Medicine, Al-Azhar University, Cairo, Egypt

    Anas Zakarya Nourelden & Abdelrahman H. Hafez

  6. Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589, Saudi Arabia

    Ahmed E. Altyar

  7. Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia

    Ghadeer M. Albadrani

  8. Faculty of Medicine, Al-Azhar University, Assiut, Egypt

    Mohamed Sayed Zaazouee

Authors
  1. Alaa Ahmed Elshanbary
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ayat Hassan Zilai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anas Ishqair
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sajeda Ghassan Matar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anas Zakarya Nourelden
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Abdelrahman H. Hafez
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ahmed E. Altyar
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ghadeer M. Albadrani
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mohamed Sayed Zaazouee
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Alaa Ahmed Elshanbary: conceptualization, methodology, formal analysis, writing – review and editing. Ayat Hassan Zilai: conceptualization, methodology, writing – review and editing. Anas Ishqair, Sajeda Ghassan Matar, Anas Zakarya Nourelden, Abdelrahman H. Hafez: methodology, writing – review and editing. Ahmed E. Altyar, Ghadeer M. Albadrani: methodology, formal analysis, writing – review and editing. Mohamed Sayed Zaazouee: conceptualization, formal analysis, writing – review and editing, supervision.

Corresponding author

Correspondence to Alaa Ahmed Elshanbary.

Ethics declarations

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publish

All authors have approved the manuscript and agree with its submission to "Environmental Science and Pollution Research".

Competing interests

The authors have no relevant interests to disclose.

Additional information

Responsible Editor: Lotfi Aleya

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 35 KB)

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Elshanbary, A.A., Zilai, A.H., Ishqair, A. et al. Demographic and treatment risk factors of cancer-specific mortality among children and adolescent leukemia patients: a population-based study. Environ Sci Pollut Res 30, 19182–19193 (2023). https://doi.org/10.1007/s11356-022-23425-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11356-022-23425-7

Keywords

Search

Navigation