Hamid Reza Khalkhali - Patient Safety Research Center, Department of Biostatistics and Epidemiology, Urmia University of Medical Sciences, Urmia, Iran
Mehran Noroozi - Department of Pediatric Hematology, Motahari Hospital, Urmia University of Medical Sciences, Urmia, Iran
Robabeh Bahadori - Department of Pediatrics, Urmia University of Medical Sciences, Urmia, Iran
Tahereh Omidi - Department of Biostatistics, Hamadan University of Medical Sciences, Hamadan, Iran
Farid Ghazizadeh - Department of Pediatric Hematology, Motahari Hospital, Urmia University of Medical Sciences, Urmia, Iran
Sasan Hejazi - Department of Pediatric Hematology, Motahari Hospital, Urmia University of Medical Sciences, Urmia, Iran
Masoumeh Mahdi-Akhgar - Solid Tumor Research Center, Urmia University of Medical Sciences, Urmia, Iran
Rohollah Valizadeh - Urmia University of Medical Sciences, Urmia, Iran

Background: Acute lymphoblastic leukemia (ALL) accounts for ۲۵% of cancers among children less than ۱۵ years of age. This study aimed to evaluate and determine the prognostic factors affecting the survival of leukemia patients using cumulative incidence function.Method: This was a retrospective study done on ۱۷۶ children under ۱۵ who had ALL between ۲۰۱۱ and ۲۰۱۹. Overall survival, event-free survival, disease-free survival (DFS), and non-relapse mortality served as the study's endpoints. Using the Fine-Gray model, the Kaplan-Meier, single-variable, and multivariable analyses were conducted. Schwenfeld weighted residuals were used to test the proportional hazard hypothesis. SAS was used to conduct the analysis.Results: The hazard ratio (HR) of DFS for effective variables was calculated (girls compared to boys: ۰.۳۷ [۹۵% confidence interval (CI): ۰.۱۵-۰.۹۱], positive testis test: ۱۰.۳۴ [۹۵% CI: ۴.۴۴-۲۴.۰۵], children with central nervous system involvement: ۲.۹۵ [۹۵% CI: ۱.۳۶-۶.۴۰], testicular swelling in children: ۱۱.۵۴ [۹۵% CI: ۴.۲۱-۳۱.۵۹], children with hepatosplenomegaly larger than ۲ cm: ۰.۳۰ [۹۵% CI: ۰.۱۰-۰.۸۸], high risk of disease compared to low risk: ۴.۷۶ [۹۵% CI: ۱.۱۲-۲۰.۲۲], children with complete remission in ۲۸th day compared with no complete remission: ۰.۱۰ [۹۵% CI: ۰.۰۴- ۰.۲۵]. Only hemoglobin was substantially linked with DFS in the multivariate DFS HR. Children who got radiation had a ۷۷% reduced risk of non-recurrence death than those who did not (HR: ۰.۲۳, ۹۵% CI: ۰.۰۸-۰.۶۰).Conclusion: Being a girl, having family history, and not having radiotherapy were the main factors to develop death before the first recurrence in children.

Leukemia, Neoplasms, Child, Survival