{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:15:41Z","timestamp":1784546141358,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T00:00:00Z","timestamp":1674691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The survival of childhood leukemia has improved. We aimed to report the survival rate and the associated factors in children with acute leukemia during an 8\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study investigates the 8\u2010year survival rates of children with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) in Shiraz, the largest oncology center in Southern Iran. We also aimed to assess the independent factors associated with higher mortality in childhood leukemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children 0\u201318\u2009years with acute leukemia were followed from 2013 to 2021 in Shiraz, Iran. The 8\u2010year overall survival (OS) and event\u2010free survival (EFS) rates were estimated by the Kaplan\u2013Meier method. Independent factors associated with survival were assessed by the Cox regression hazard modeling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 786 children, with 43.5% female, and a mean age of 6.32\u2009\u00b1\u20094.62\u2009years. Patients with AML compared to ALL experienced more relapse (34.6% vs. 22.5%,<jats:italic>p<\/jats:italic>\u00a0=\u00a0.01) and death (31.7% vs. 11.3%,<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). The cumulative 8\u2010year OS and EFS were 81% (95% confidence interval (CI), 74.3% to 86.1%) and 68.3% (95% CI, 63.5% to 72.7%) in ALL patients and 63.5% (95% CI, 52.1% to 72.9%) and 43% (95% CI, 33.1% to 52.6%) in AML patients. Multivariable analysis revealed that hepatomegaly (hazard ratio\u00a0=\u00a04, 95% CI, 1.0 to 22.3,<jats:italic>p<\/jats:italic>\u00a0=\u00a0.05) was the main independent risk factor of death in ALL patients. No definite risk factor was defined for AML patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The survival of childhood leukemia has recently increased dramatically in low\u2010middle income countries. Hepatomegaly was introduced as a potential risk factor for lower survival in ALL patients. Further multicenter studies are needed to confirm the validity of this association.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1784","type":"journal-article","created":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T10:49:19Z","timestamp":1674730159000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The survival of childhood leukemia: An 8\u2010year single\u2010center experience"],"prefix":"10.1002","volume":"6","author":[{"given":"Mohammadreza","family":"Bordbar","sequence":"first","affiliation":[{"name":"Hematology Research Center Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazila","family":"Jam","sequence":"additional","affiliation":[{"name":"Pediatrics Department, Medical School Shiraz University of Medical Sciences Shiraz 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