title: Childhood acute lymphoblastic leukemia: refusal and abandonmentof treatment in the southeast of Iran.
abstract: OBJECTIVE
  Acute lymphoblastic leukemia (ALL) accounts for 25% of all malignancies in children. ALL treatment has standard protocols, and treatment abandonment is a main cause of treatment failure. Therefore, this study aimed to assess the relationship between socioeconomic status and rate as well as cause of abandoned treatment in children with ALL in the southeast of Iran.
  
  
  METHODS
  This retrospective, descriptive cohort study was conducted with ALL patients at the Ali Asghar Hospital in the city of Zahedan. The study population included 22 children with different subtypes of ALL who had abandoned their treatment. A structural questionnaire was filled out by patients or their parents. Results were assessed using descriptive and analytical tests.
  
  
  RESULTS
  The rate of treatment abandonment was 24.4% (22 patients).We had 18 ALL-L1 (78.3%) and four ALL-L2 (17.4%) patients. Reasons for treatment abandonment were low family income, transportation difficulties, the father's education status, conviction about ALL's incurability, and reference to spiritual means, respectively.
  
  
  CONCLUSIONS
  Low family income, transportation difficulties, the father's education status, belief about ALL's incurability, and reference to spiritual means were the most common associations with ALL treatment abandonment in that order. Financial problems in this part of the country can impose high costs to the healthcare system.
authors: Genetic Researcher Center in Non-Communicable Diseases, Zahedan University of Medical Sciences, Zahedan, Iran.
authors: Majid
authors: M
authors: Naderi
authors: Department of Hematology and Blood Transfusion, Students Research Center, School of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors: Samira
authors: S
authors: Esmaeili Reykande
authors: Department of Hematology and Blood Transfusion, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran.
authors: Shadi
authors: S
authors: Tabibian
authors: Department of Hematology and Blood Transfusion, Students Research Center, School of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors: Shaban
authors: S
authors: Alizadeh
authors: Department of Hematology and Blood Transfusion, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran.
authors: Akbar
authors: A
authors: Dorgalaleh
authors: School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
authors: Morteza
authors: M
authors: Shamsizadeh
mesh_terms: D006801:Humans; D007492:Iran; D010290:Parents; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: Acute lymphoblastic leukemia; socioeconomic status; treatment abandonment