1. Adolescence and Socioeconomic Factors: Key Factors in the Long-Term Impact of Leukemia on Scholastic Performance—A LEA Study
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Sandrine Thouvenin, Nicolas Sirvent, André Baruchel, Jacinthe Bonneau, Catherine Paillard, Camille Vercasson, Pascal Auquier, Marie Dominique Tabone, Yves Bertrand, Virginie Gandemer, Maryline Poirée, Jean-Hugues Dalle, Paul Saultier, Audrey Contet, Sophie Ansoborlo, Claire Freycon, Gérard Michel, Julie Berbis, Justyna Kanold, CHU Pontchaillou [Rennes], Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Service de pédiatrie multidisciplinaire [Hôpital de la Timone Enfants - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE), Institut d'hématologie et d'oncologie pédiatrique [CHU - HCL] (IHOPe), Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, CHU Bordeaux [Bordeaux], Unité d'Hémato-Immunologie pédiatrique [Hôpital Robert Debré, Paris], Service d'Immuno-hématologie pédiatrique [Hôpital Robert Debré, Paris], Hôpital Robert Debré-Hôpital Robert Debré, CHU Strasbourg, Service d'Oncologie Pédiatrique [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Universitaire de Nice (CHU Nice), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Centre d'Investigation Clinique - Innovation Technologique - INSERM - CHU de Grenoble (CIC-IT Grenoble (CIT803)), CHU Grenoble-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Saint-Etienne, and CCSD, Accord Elsevier
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Male ,Childhood leukemia ,Health Status ,Childhood Cancer Survivor Study ,Logistic regression ,Risk Assessment ,school performance ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Humans ,Medicine ,childhood cancer ,acute leukemia ,Child ,Socioeconomic status ,Acute leukemia ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,Leukemia ,business.industry ,Incidence ,school impact ,medicine.disease ,3. Good health ,Survival Rate ,Cross-Sectional Studies ,Socioeconomic Factors ,030220 oncology & carcinogenesis ,adolescent ,long-term survivors ,Pediatrics, Perinatology and Child Health ,Cohort ,Quality of Life ,social impact ,Female ,France ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Follow-Up Studies ,Forecasting ,030215 immunology ,Social status ,Demography - Abstract
International audience; 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 were male sex (OR, 1.78; 95% CI, 1.21-2.60), adolescence (OR, 2.70; 95% CI, 1.63-4.48), educational support during the 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 were at 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.
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- 2019
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