ArticleCancer2022
Sex-based disparities in outcome in pediatric acute lymphoblastic leukemia: a Children's Oncology Group report.
Article in Cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 30 citations in OpenAlex.
- Excess body weight at diagnosis is associated with inferior ALL outcomes in male adolescents in the ALL-BFM 2000 study.Blood neoplasia · 2026Article
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- Central nervous system involvement and relapse in adult acute lymphoblastic leukaemia-a population-based analysis in 2007-2022.British journal of haematology · 2026Article
- Outcomes of children with T-cell acute lymphoblastic leukemia treated with the JACLS T-02 protocol.International journal of hematology · 2026Article
- Epidemiology, survival, and treatment of acute myeloid and lymphoblastic leukaemia in Germany: a nationwide population-based registry analysis.The Lancet regional health. Europe · 2025Article
- Influence of social support on the social adaptive behaviors of children with acute leukemia in China: the mediating role of family functioning.BMC pediatrics · 2025Article
- Age and Sex Differences in the Prevalence of Specific Comorbidities among Patients with Pediatric Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma at Diagnosis.Cancer research communications · 2025Article
- Article
- Prediction of Response to FDA-Approved Targeted Therapy and Immunotherapy in Acute Lymphoblastic Leukemia (ALL).Current treatment options in oncology · 2024Review
- The global burden of childhood and adolescent leukaemia and attributable risk factors: An analysis of the Global Burden of Disease Study 2019.Journal of global health · 2024Article
- Clinical Characteristics and Cytogenetics of Childhood Acute Lymphoblastic Leukemia in a Single Center in Pakistan.Global pediatric health · 2024Article
- Children's Oncology Group's 2023 blueprint for research: Diversity and health disparities.Pediatric blood & cancer · 2023Article
- The Relationship between Gene Polymorphisms od the XRCC1 and TP53 with the Gender of Children with Acute Leukemia.Asian Pacific journal of cancer prevention : APJCP · 2023Article
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Authors and funding
19 authors at 16 institutions in 2 countries.
Funding
Abstract
backgroundBoys with acute lymphoblastic leukemia (ALL) have historically experienced inferior survival compared to girls. This study determined whether sex-based disparities persist with contemporary therapy and whether patterns of treatment failure vary by sex.
methodsPatients 1 to 30.99 years old were enrolled on frontline Children's Oncology Group trials between 2004 and 2014. Boys received an additional year of maintenance therapy. Sex-based differences in the distribution of various prognosticators, event-free survival (EFS) and overall survival (OS), and subcategories of relapse by site were explored.
resultsA total of 8202 (54.4% male) B-cell ALL (B-ALL) and 1562 (74.3% male) T-cell ALL (T-ALL) patients were included. There was no sex-based difference in central nervous system (CNS) status. Boys experienced inferior 5-year EFS and OS (EFS, 84.6% ± 0.5% vs 86.0% ± 0.6%, P = .009; OS, 91.3% ± 0.4% vs 92.5% ± 0.4%, P = .02). This was attributable to boys with B-ALL, who experienced inferior EFS (hazard ratio [HR], 1.2; 95% confidence interval [95% CI], 1.1-1.3; P = .004) and OS (HR, 1.2; 95% CI, 1.0-1.4; P = .046) after adjustment for prognosticators. Inferior B-ALL outcomes in boys were attributable to more relapses (5-year cumulative incidence 11.2% ± 0.5% vs 9.6% ± 0.5%; P = .001), particularly involving the CNS (4.2% ± 0.3% vs 2.5% ± 0.3%; P < .0001). There was no difference in isolated bone marrow relapses (5.4% ± 0.4% vs 6.2% ± 0.4%; P = .49). There were no sex-based differences in EFS or OS in T-ALL.
conclusionsSex-based disparities in ALL persist, attributable to increased CNS relapses in boys with B-ALL. Studies of potential mechanisms are warranted. Improved strategies to identify and modify treatment for patients at highest risk of CNS relapse may have particular benefit for boys.
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