Adolescence and Socioeconomic Factors: Key Factors in the Long-Term Impact of Leukemia on Scholastic Performance—A LEA Study - 24/01/19
, Julie Berbis, MD, PhD 2, *, Gerard Michel, MD, PhD 2, 3, Camille Vercasson, MS 2, Yves Bertrand, MD, PhD 4, Sophie Ansoborlo, MD 5, Jean-Hugues Dalle, MD, PhD 6, Andre Baruchel, MD, PhD 6, Marie Dominique Tabone, MD 7, Catherine Paillard, MD, PhD 8, Audrey Contet, MD 9, Maryline Poirée, MD 10, Nicolas Sirvent, MD, PhD 11, Sandrine Thouvenin, MD 12, Justyna Kanold, MD, PhD 13, Claire Freycon, MD 14, Paul Saultier, MD 3, Pascal Auquier, MD, PhD 2, Virginie Gandemer, MD, PhD 1Abstract |
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.
Le texte complet de cet article est disponible en PDF.Keywords : adolescent, social impact, long-term survivors, acute leukemia, school performance, school impact, childhood cancer
Abbreviations : AL, CNS, HSCT, LEA
Plan
| Funded by the French National Clinical Research Program, the French National Cancer Institute, the French National Research Agency, the French League Against Cancer, the Cancéropôle of Provence-Alpes-Côte d'Azur, the Regional Council of Provence-Alpes-Côte d'Azur, the Hérault and Bouches-du-Rhone Departmental Committees of the League Against Cancer and the French Institute for Public Health Research. The authors declare no conflicts of interest. |
Vol 205
P. 168 - février 2019 Retour au numéro
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