机构：[1]Department of Hematology/Oncology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Key Lab of Pediatric Hematology and Oncology of China Ministry of Health, and National Children’s Medical Center, Shanghai, China[2]Department of Hematology/Oncology, Chongqing Medical University Affiliated Children’s Hospital, Chongqing, China[3]Department of Pediatrics, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China[4]Department of Hematology/Oncology, Children’s Hospital of Soochow University, Suzhou, China[5]Department of Pediatrics, West China Second University Hospital of Sichuan University, Chengdu, China[6]Department of Hematology/Oncology, Guangzhou Women and Children’s Health Care Center, Guangzhou, China[7]Department of Pediatrics, Southern Medical University Affiliated Nanfang Hospital, Guangzhou, China[8]Department of Hematology/Oncology, Nanjing Children’s Hospital Affiliated to Nanjing Medical University, Nanjing, China[9]Department of Hematology/Oncology, Jiangxi Provincial Children’s Hospital, Nanchang, China[10]Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China[11]Department of Hematology/Oncology, Kunming Children’s Hospital, Kunming, China[12]Department of Hematology/Oncology, Children’s Hospital of Fudan University, Shanghai, China[13]Department of Pediatrics, Huazhong University of Science and Technology Tongji Medical College Union Hospital, Wuhan, China[14]Department of Pediatrics, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Wuhan, China[15]Department of Pediatrics, Anhui Medical University Second Affiliated Hospital, Hefei, China[16]Department of Hematology/Oncology, Children’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China[17]Department of Pediatrics, Qingdao University Affiliated Hospital, Qingdao, China[18]Deparment of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong[19]Department of Hematology/Oncology, Northwest Women’s and Children’s Hospital, Xi’an, China[20]Department of Pediatrics, Xiangya Hospital Central South University, Changsha, Hunan, China[21]Department of Biostatistics, St Jude Children’s Research Hospital, Memphis, Tennessee, USA[22]Department of Oncology, St Jude Children’s Research Hospital, Memphis, USA
Before 2003, most children with acute lymphoblastic leukaemia (ALL) abandoned treatment, with only approximately 30% treated in China. With the development of national insurance for underprivileged patients, we assessed the current frequency and causes of treatment abandonment among patients with ALL who were enrolled in the Chinese Children's Cancer Group ALL protocol between 2015 and 2016.
Demographic, clinical and laboratory data on patients who abandoned treatment, as well as economic and sociocultural data of their families were collected and analysed. General health-related statistics were retrieved from publicly accessible databanks maintained by the Chinese government.
At a median follow-up of 119 weeks, 83 (3.1%, 95% CI 2.5% to 3.8%) of the 2641 patients abandoned treatment. Factors independently associated with abandonment included standard/high-risk ALL (OR 2.62, 95%?CI 1.43 to 4.77), presence of minimal residual disease at the end of remission induction (OR 3.57, 95%?CI 1.90 to 6.74) and low-income economic region (OR 3.7, 95%?CI 1.89 to 7.05). According to the family members, economic constraints (50.6%, p=0.0001) were the main reason for treatment abandonment, followed by the belief of incurability, severe side effects and concern over late complications.
The rate of ALL treatment abandonment has been greatly reduced in China. Standard/high-risk ALL, residence in a low-income region and economic difficulties were associated with treatment abandonment.
ChiCTR-IPR-14005706, pre-results.
? Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
基金：
Funding for this work was provided by the NCI grant CA21765, the
National Natural Science Foundation of China (No 81670136, to JT) and the
American Lebanese and Syrian Associated Charities (ALSAC).
第一作者机构：[1]Department of Hematology/Oncology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Key Lab of Pediatric Hematology and Oncology of China Ministry of Health, and National Children’s Medical Center, Shanghai, China
通讯作者：
通讯机构：[*1]Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee, USA[*2]Department of Hematology/ Oncology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Key Lab of Pediatric Hematology and Oncology of China Ministry of Health, Shanghai 200127, China
推荐引用方式(GB/T 7714)：
Jiaoyang Cai ,Jie Yu ,Xiaofan Zhu ,et al.Treatment abandonment in childhood acute lymphoblastic leukaemia in China: a retrospective cohort study of the Chinese Children's Cancer Group.[J].Archives of disease in childhood.2019,104(6):522-529.doi:10.1136/archdischild-2018-316181.
APA：
Jiaoyang Cai,,Jie Yu,,Xiaofan Zhu,,Shaoyan Hu,,Yiping Zhu,...&Jingyan Tang,.(2019).Treatment abandonment in childhood acute lymphoblastic leukaemia in China: a retrospective cohort study of the Chinese Children's Cancer Group..Archives of disease in childhood,104,(6)
MLA：
Jiaoyang Cai,,et al."Treatment abandonment in childhood acute lymphoblastic leukaemia in China: a retrospective cohort study of the Chinese Children's Cancer Group.".Archives of disease in childhood 104..6(2019):522-529
