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|Title: ||Influence of Length of Time to Diagnosis and Treatment on the Survival of Children with Acute Lymphoblastic Leukemia and Hodgkin Disease: A Population-based Study|
|Authors: ||Baker, Jillian M.|
|Advisor: ||Sung, Lillian|
|Department: ||Health Policy, Management and Evaluation|
|Issue Date: ||21-Jul-2010|
|Abstract: ||Introduction: Objectives were to describe time intervals between presentation to a tertiary care center, diagnosis and treatment in pediatric acute lymphoblastic leukemia (ALL) and Hodgkin disease (HD), and measure their impact on overall survival (OS) and event-free survival (EFS).
Methods: Children in POGONIS (Pediatric Oncology group of Ontario Networked Information System) with ALL or HD from 1997-2007 were eligible. Time intervals were dichotomized at clinically defined cut-points. OS and EFS were examined with univariate and multivariable Cox proportional hazards (CPH) models.
Results: In ALL, in multivariable analysis, those with treatment > 3 days after diagnosis had inferior OS (adjHR=2.49; 95%CI 1.4-4.43;p=0.002), and inferior EFS (adjHR=1.73; 95%CI 1.01-2.96;p=0.047). In HD, in multivariable analysis, those with treatment > 7 days after diagnosis had superior EFS (adjHR=0.37; 95%CI 0.18-0.77;p=0.008).
Conclusions: Time to treatment is associated with survival in ALL and HD. Future research will further delineate the relationship between time to treatment and outcome.|
|Appears in Collections:||Master|
The Institute of Health Policy, Management and Evaluation - Master theses
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