RT Journal Article
SR Electronic
T1 Treatment abandonment in childhood acute lymphoblastic leukaemia in China: a retrospective cohort study of the Chinese Children’s Cancer Group
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 522
OP 529
DO 10.1136/archdischild-2018-316181
VO 104
IS 6
A1 Jiaoyang Cai
A1 Jie Yu
A1 Xiaofan Zhu
A1 Shaoyan Hu
A1 Yiping Zhu
A1 Hua Jiang
A1 Chunfu Li
A1 Yongjun Fang
A1 Changda Liang
A1 Xiuli Ju
A1 Xin Tian
A1 Xiaowen Zhai
A1 Jinjin Hao
A1 Qun Hu
A1 Ningling Wang
A1 Hui Jiang
A1 Lirong Sun
A1 Chi Kong Li
A1 Kaili Pan
A1 Minghua Yang
A1 Shuhong Shen
A1 Cheng Cheng
A1 Raul C Ribeiro
A1 Ching-Hon Pui
A1 Jingyan Tang
A1 ,
YR 2019
UL http://adc.bmj.com/content/104/6/522.abstract
AB Objectives 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.Methods 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.Results 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.Conclusions 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.Clinical trial registration number ChiCTR-IPR-14005706, pre-results.