Determining the Survival Rate in Children with ALL in the Northeast of Iran via Competing Risks Approach
Background: We designed this study to assess the significant prognostic factors of both recurrence and death in patients with acute lymphoblastic leukemia in a university-based hospital using a parametric competing risks model. Methods: In this retrospective study, we included 417 patients with a...
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doaj-bb120e161af542c4bb874440b7ada9cb2020-11-25T03:36:42ZengShiraz University of Medical SciencesMiddle East Journal of Cancer 2008-67092008-66872020-07-0111335135910.30476/mejc.2020.81284.0Determining the Survival Rate in Children with ALL in the Northeast of Iran via Competing Risks ApproachAnahita Saeedi0Ahmadreza Baghestani1Hossein Bonakchi2Abbas Khosravi3Hamid Farhangi4Zahra Badiei5Ali Ghasemi6Abdollah Banihashem7Maryam Forouzannejhad8Department of Biostatistics, Shahid Beheshti University of Medical Sciences, Tehran, IranPhysiotherapy Research Center, Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IranDepartment of Biostatistics, Shahid Beheshti University of Medical Sciences, Tehran, IranLaboratory Hematology and Blood Banking Blood, Tehran, IranDepartment of Pediatrics Hematology and Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Pediatrics Hematology and Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Pediatrics Hematology and Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Pediatrics Hematology and Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Pediatrics Hematology and Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranBackground: We designed this study to assess the significant prognostic factors of both recurrence and death in patients with acute lymphoblastic leukemia in a university-based hospital using a parametric competing risks model. Methods: In this retrospective study, we included 417 patients with acute lymphoblastic leukemia. Staining of bone marrow smears with Giemsa method confirmed the diagnosis, justifying at least 25% lymphoblast. Treatment of patients was based on the Berlin-Frankfurt-Münster (BFM) protocol. We considered the first recurrence of cancer as the event of interest and non-relapse mortality as a competing risk. The employed two-parameter Weibull model accounted for both the interest and the competing events. Results: The relapse-free survival and the five-year overall mortality rates of patients were 85.9% and 74%, respectively. The majority of the patients (72.7%) did not experience any event during the study period. We explained these events as first recurrence and non-relapse mortality, which occurred in 44 (10.6%) and 70 (16.8%) of the patients in the given order. The cumulative incident probability of the first recurrence and non-relapse mortality, were 13.43% and 18.61%, respectively. Conclusion: Based on the model, we identified white blood cell count and central nervous system involvement as important prognostic factors in determining the incidence rate. Therefore, they must be considered in the selection of treatment plan and risk stratification.https://mejc.sums.ac.ir/article_46726.htmlsurvival analysisacute lymphoblastic leukemiaparametric competing risks modelcumulative incidence probability |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anahita Saeedi Ahmadreza Baghestani Hossein Bonakchi Abbas Khosravi Hamid Farhangi Zahra Badiei Ali Ghasemi Abdollah Banihashem Maryam Forouzannejhad |
spellingShingle |
Anahita Saeedi Ahmadreza Baghestani Hossein Bonakchi Abbas Khosravi Hamid Farhangi Zahra Badiei Ali Ghasemi Abdollah Banihashem Maryam Forouzannejhad Determining the Survival Rate in Children with ALL in the Northeast of Iran via Competing Risks Approach Middle East Journal of Cancer survival analysis acute lymphoblastic leukemia parametric competing risks model cumulative incidence probability |
author_facet |
Anahita Saeedi Ahmadreza Baghestani Hossein Bonakchi Abbas Khosravi Hamid Farhangi Zahra Badiei Ali Ghasemi Abdollah Banihashem Maryam Forouzannejhad |
author_sort |
Anahita Saeedi |
title |
Determining the Survival Rate in Children with ALL in the Northeast of Iran via Competing Risks Approach |
title_short |
Determining the Survival Rate in Children with ALL in the Northeast of Iran via Competing Risks Approach |
title_full |
Determining the Survival Rate in Children with ALL in the Northeast of Iran via Competing Risks Approach |
title_fullStr |
Determining the Survival Rate in Children with ALL in the Northeast of Iran via Competing Risks Approach |
title_full_unstemmed |
Determining the Survival Rate in Children with ALL in the Northeast of Iran via Competing Risks Approach |
title_sort |
determining the survival rate in children with all in the northeast of iran via competing risks approach |
publisher |
Shiraz University of Medical Sciences |
series |
Middle East Journal of Cancer |
issn |
2008-6709 2008-6687 |
publishDate |
2020-07-01 |
description |
Background: We designed this study to assess the significant prognostic factors
of both recurrence and death in patients with acute lymphoblastic leukemia in a
university-based hospital using a parametric competing risks model.
Methods: In this retrospective study, we included 417 patients with acute
lymphoblastic leukemia. Staining of bone marrow smears with Giemsa method
confirmed the diagnosis, justifying at least 25% lymphoblast. Treatment of patients
was based on the Berlin-Frankfurt-Münster (BFM) protocol. We considered the first
recurrence of cancer as the event of interest and non-relapse mortality as a competing
risk. The employed two-parameter Weibull model accounted for both the interest and
the competing events.
Results: The relapse-free survival and the five-year overall mortality rates of
patients were 85.9% and 74%, respectively. The majority of the patients (72.7%) did
not experience any event during the study period. We explained these events as first
recurrence and non-relapse mortality, which occurred in 44 (10.6%) and 70 (16.8%)
of the patients in the given order. The cumulative incident probability of the first
recurrence and non-relapse mortality, were 13.43% and 18.61%, respectively.
Conclusion: Based on the model, we identified white blood cell count and central
nervous system involvement as important prognostic factors in determining the
incidence rate. Therefore, they must be considered in the selection of treatment plan
and risk stratification. |
topic |
survival analysis acute lymphoblastic leukemia parametric competing risks model cumulative incidence probability |
url |
https://mejc.sums.ac.ir/article_46726.html |
work_keys_str_mv |
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