The Survival of Childhood Acute Lymphoblastic Leukemia and its Related Factors Using Competing Risks Model: A Retrospective Study from 2011 to 2019 in Northwestern Iran

We aimed to evaluate the survival rate and define the prognostic
factors in children with acute lymphoblastic leukemia (ALL).
Method: In this retrospective study, the data were extracted from the medical
records of 176 children with ALL who referred to Motahari Hospital in Urmia from
2011 to 2019. Endpoints of overall survival study were event-free survival, disease-
free survival, and recurrent mortality. Overall survival and disease-free survival were
the time from diagnosis to death of any cause or recurrence. Event-free survival time
was calculated as the distance from the date of diagnosis to the date of the last
prevention with the first event. Non-recurrent mortality included all non-recurrent
deaths. Data analysis was performed using a cause-specific hazard model.
Results: The mean age of the patients was 5.61 ± 3.56 years and the median of
diagnosis of ALL to death was 3.47 ± 2.61 years. The 1-year, 3- year and 5-year probability
of survival were 83.1%, 75.10%, and 68%, respectively. Sex, hemoglobin level, and
hepatosplenomegaly were significant in univariate and multivariate analysis (P < 0.05).
Conclusion: The competing risks model was applied to identify the risk factors
for all causes of death. The factors affecting the survival rate of patients in the model
can be employed in making clinical decisions and proposing therapeutic protocols.
Furthermore, it reduces the duration of response to therapy, thereby decreasing the
rate of mortality in children