Objective

To evaluate the association between medical and social environmental factors and the risk of repeating a grade in childhood leukemia survivors.

Study design

A cross-sectional study of childhood leukemia survivors, recruited through the LEA cohort (Leucémie de l’Enfant et de l’Adolescent [French Childhood Cancer Survivor Study for Leukemia]) in 2014. An adjusted logistic regression model was used to identify variables linked to repeating a grade after the diagnosis among the survivors, and the rates of repeating a grade were compared between the survivors and their siblings using a multilevel logistic regression model.

Results

The mean age at inclusion of the 855 participants was 16.2±7.0 years, and the mean duration of follow-up from diagnosis to evaluation was 10.2±6.2 years. After disease onset, 244 patients (28.5%) repeated a grade,with a median interval of 4 years (IQR, 2-8 years). Independent factors associated with repeating a grade weremale sex (OR, 1.78; 95% CI, 1.21-2.60), adolescence (OR, 2.70; 95% CI, 1.63-4.48), educational support duringthe treatment period (OR, 3.79; 95% CI, 2.45-5.88), low parental education level (OR, 2.493; 95% CI, 1.657-3.750), and household financial difficulties (OR, 2.62; 95% CI, 1.607-4.28). Compared with siblings, survivors wereat greater risk of repeating a grade (OR, 1.87; 95% CI, 1.48-2.35).

Conclusions

The most vulnerable patients seemed to be adolescents and those with parents of low socioeconomic status. Improving the schooling career of leukemia survivors will require that the medical community more carefully consider the social status of patients.

The Journal of Pediatrics. 2018 Feb;205:168-175.e2.

Objective

Study design

Results

Conclusions

Consult other publications

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