A study conducted by researchers from the Epidemiology & Genetics Unit in the Department of Health Sciences at University of York that was published online in the European Journal of Cancer revealed that children with leukemia from less-affluent backgrounds or areas are more likely to die.

Each year 450 children are diagnosed with acute lymphoblastic leukemia (ALL). It is the most common form of cancer in children and treatment is lengthy and complex, with current treatments continuing two years for girls and three years for boys. In the first treatment phase clinicians try to put the disease into remission, which means the majority of children spend the first nine months of their therapy in hospital. Significantly the researchers discovered that there was no difference in survival by social group during the first phase of the treatment.

In their study researchers followed the treatment outcome of children diagnosed with ALL from 1991 to 1996 using data obtained from the United Kingdom Childhood Cancer Study. The children were categorized into different social classes, which were determined either by their father’s employment status as recorded at birth or through the children’s post-code-based deprivation score at the time of diagnosis.

They noted that differences started to develop 6 to 9 months after diagnosis and became even more obvious once treatment changed from being predominantly administered by the hospital to becoming the main responsibility of parents or carers, suggesting that parents or carers may experience problems in complying with the difficult home-based maintenance treatment.

The treatment consists of daily drug administrations in 12-week cycles. During these cycles the frequency and timing of prescribed doses are different depending on the drug but also on a day-to-day basis. It is extremely challenging to comply with these treatment regimens over a period of several years, particularly as the children usually appear to be well, yet maintenance drugs are vitally crucial. They prevent children from experiencing relapses as survival rates for children who relapse is still poor.

Scientific Director Dr. David Grant at the charity Leukemia & Lymphoma Research, who funded the research, declares:

“We know every parent wants to do their best for their children. Managing the precise regimen of drugs in the home is stressful for any family caring for a child with leukemia, especially as the child already appears to be completely cured. We need to do more work to find out what support parents or carers need during the two to three years after their child leaves hospital. Thanks to the work of Leukemia & Lymphoma Research, over 90% of children now survive the most common form of leukemia. We need to make sure every child is cured and this research suggests that helping with treatment compliance will take us a step towards achieving this.”

For nearly 16 years researchers followed more than 1,500 children diagnosed with acute lymphoblastic leukemia (ALL), establishing that death rates varied with socio-economic indicators. Their study showed that children from more deprived families had a higher risk of mortality. They also made the important discovery that the same study proved earlier that there were no variations between social groups regarding the possibility of whether or not a child would develop ALL in the first place.

Research leader, Dr Tracy Lightfoot, of the Department of Health Sciences at the University of York, commented:

“The findings from this study provide the first clear evidence in the UK that social disparities exist in relation to childhood leukemia survival. Importantly this variation is not due to differential treatment across social groups and was the same when children who were not enrolled in clinical trials were excluded from the analysis.”

Written by Petra Rattue