Jacinthe Bonneau, Julie Berbis, Gérard Michel, Camille Vercasson, Yves Bertrand, Sophie Ansoborlo, Jean-Hugues Dalle, André Baruchel, Marie-Dominique Tabone, Catherine Paillard, Audrey Contet, Maryline Poirée, Nicolas Sirvent, Sandrine Thouvenin, Justyna Kanold, Claire Freycon, Paul Saultier, Pascal Auquier and Virginie Gandemer.
The Journal of Pediatrics. 2018 Feb;205:168-175.e2.
To evaluate the association between medical and social environmental factors and the risk of repeating a grade in childhood leukemia survivors.
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.
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).
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.