Características da mortalidade e fatores relacionados ao óbito em crianças e adolescentes com baixo nível socioeconômico em tratamento para leucemia linfoide aguda

Abstract

Introduction: The outcomes of treatment of Acute Lymphoid Leukemia (ALL) in childhood in developing countries are inferior than those reported in developed nations. Socio- economic factors are potential predictors of mortality in this setting. The present study aims to assess the impact of socioeconomic characteristics on childhood ALL mortality. Methods: This is a longitudinal, prospective cohort study. Pacients up to 19 year, diagnosed with immunophe- notyping of peripheral blood or bone marrow between 2005 and October 2016. Results: We collected clinical, demographic and socioeconomic data at diagnosis and analyzed the impact of these variables on survival, death on induction and relapse. We analyzed 131 patients. The mean age was 8 years with standard deviation of 5 years. Death throughout all phases of treat- ment was recorded in 58 cases (43.6%). Most (69%) were secondary to sepsis.). Death occurred at induction In 31 cases (54.4%). Among the variables studied, only age equal or superior to 9 years, categorization as "high risk" for relapse and infectious event on IR were associated with death throughout the treatment. Categorization as "high risk" for relapse at diagnosis was asso- ciated with a higher risk of relapse. Conclusions: Realistic and accessible measures for the prevention, diagnosis and immediate treatment of infectious episodes need to be tested and rapidly implemented in services with high morbidity due to infection among children and ado- lescents receiving treatment for ALL.