title: Impact of age on the survival of pediatric leukemia: an analysis of 15083 children in the SEER database.
abstract: OBJECTIVE
  Age at diagnosis is a key factor for predicting the prognosis of pediatric leukemia especially regarding the survivorship assessment. In this study, we aimed to assess the impact of this prognostic factor such as age in children with pediatric leukemia.
  
  
  METHODS
  In this study, Surveillance, Epidemiology, and End Results Program-registered children with leukemia during 1988-2013 were analyzed. All patients were divided into five groups according to the age at the time of diagnosis (<1, 1-4, 5-9, 10-15, >15 years old). Kaplan-Meier and multivariable Cox regression models were used to evaluate leukemia survival outcomes and risk factors.
  
  
  RESULTS
  There was significant variability in pediatric leukemia survival by age at diagnosis including ALL, AML and CML subtypes. According to the survival curves in each group, survival rate were peaked among children diagnosed at 1-4 years and steadily declined among those diagnosed at older ages in children with ALL. Infants (<1 year) had the lowest survivorship in children with either ALL or AML. However, children (1-4 years) harbored the worst prognosis suffering from CML. A stratified analysis of the effect of age at diagnosis was validated as independent predictors for the prognosis of pediatric leukemia.
  
  
  CONCLUSIONS
  Age at diagnosis remained to be a crucial determinant of the survival variability of pediatric leukemia patients.
authors: Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China.
authors: Yaping
authors: Y
authors: Wang
authors: Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China.
authors: Jie
authors: J
authors: Huang
authors: Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China.
authors: Liucheng
authors: L
authors: Rong
authors: Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China.
authors: Peng
authors: P
authors: Wu
authors: Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China.
authors: Meiyun
authors: M
authors: Kang
authors: Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China.
authors: Xuejie
authors: X
authors: Zhang
authors: Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China.
authors: Qin
authors: Q
authors: Lu
authors: Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China.
authors: Yongjun
authors: Y
authors: Fang
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D007938:Leukemia / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D018426:SEER Program; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: Kaplan-Meier; age; epidemiology; leukemia; surveillance