{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T12:57:43Z","timestamp":1765976263825,"version":"3.48.0"},"reference-count":41,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,9,14]],"date-time":"2025-09-14T00:00:00Z","timestamp":1757808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lower socioeconomic status (SES) and minority race and ethnicity are associated with lower overall survival in pediatric leukemia. Higher acuity at initial presentation is associated with mortality during induction chemotherapy. We hypothesized that the mechanism underlying these associations is differences in access to healthcare and that patients who resided in lower SES neighborhoods were more likely to have higher illness acuity at initial presentation compared to patients in higher SES neighborhoods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedure<\/jats:title>\n                    <jats:p>This retrospective cohort study included patients aged 0\u201321 diagnosed with acute leukemia and treated at a single institution from 2012 to 2022. Neighborhood SES (nSES) data from the California Neighborhoods Data System were used as a measure of access to care. Laboratory abnormalities indicative of illness acuity and intensive care unit (ICU) admission in the first 72\u00a0h of leukemia presentation were collected. Multivariable regression was used to evaluate the association between ICU admission and nSES.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 147 patients, 25% required ICU admission within the first 72\u00a0h of leukemia presentation. After adjusting for race, ethnicity, insurance, and leukemia risk group, patients in the lowest and middle nSES tertiles were 4.0 times more likely to require ICU admission compared to patients in the highest tertile (confidence interval [CI]: 1.8\u20139.1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children living in lower SES neighborhoods are significantly more likely to require ICU admission at the time of leukemia diagnosis compared to children in higher SES neighborhoods. Interventions focused on improving healthcare access may improve outcomes for groups that have been economically and socially disadvantaged.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.32049","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T04:33:37Z","timestamp":1757910817000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lower Neighborhood Socioeconomic Status Is Associated With Intensive Care Unit\u00a0Admission at Initial Presentation in Children With Acute Leukemia"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4541-8052","authenticated-orcid":false,"given":"Chynna M.","family":"Swift","sequence":"first","affiliation":[{"name":"School of Medicine University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Earl","family":"Chism","sequence":"additional","affiliation":[{"name":"Department of Pediatrics UCSF Benioff Children's Hospitals  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8948-7630","authenticated-orcid":false,"given":"Katherine","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aly","family":"Cortella","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanushree","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics UCSF Benioff Children's Hospitals  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacklyn Sanchez","family":"Alvarez","sequence":"additional","affiliation":[{"name":"UCSF Helen Diller Family Comprehensive Cancer Center  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9982-1594","authenticated-orcid":false,"given":"Lena E.","family":"Winestone","sequence":"additional","affiliation":[{"name":"Department of Pediatrics UCSF Benioff Children's Hospitals  San Francisco California USA"},{"name":"UCSF Helen Diller Family Comprehensive Cancer Center  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25928"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2022.01.001"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.15.2008"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103026(22)00371\u20104"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu572"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2016.07.007"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24605"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30726"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3322\/CA.2007.0011"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552\u2010011\u20109736\u20105"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2021.05.026"},{"key":"e_1_2_8_13_1","unstructured":"United States Census Bureau \u201cInequalities Persist Despite Decline in Poverty For All Major Race and Hispanic Origin Groups \u201dCensus.gov 2020 https:\/\/www.census.gov\/library\/stories\/2020\/09\/poverty\u2010rates\u2010for\u2010blacks\u2010and\u2010hispanics\u2010reached\u2010historic\u2010lows\u2010in\u20102019.html."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.16_suppl.11037"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2019.102193"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0237241"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2020.305656"},{"key":"e_1_2_8_18_1","unstructured":"J.Yang A.Harrati C.Clarke T.Keegan andS.Gomez \u201cDeveloping an Area\u2010Based Socioeconomic Measure From American Community Survey Data \u201dCancer Prevention Institute of California 2014."},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1011240019516"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552\u2010013\u20100310\u20101"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2015.04.011"},{"key":"e_1_2_8_22_1","unstructured":"Children's Oncology Group \u201cA Study to Compare Standard Chemotherapy to Therapy With CPX\u2010351 and\/or Gilteritinib for Patients With Newly Diagnosed AML With or Without FLT3 Mutations \u201d clinicaltrials.gov 2025 https:\/\/clinicaltrials.gov\/study\/NCT04293562."},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019\u20100748"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900\u2010014\u20109823\u20100"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.54.2.78"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000002344"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010022\u201009547\u20108"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102014\u201010\u2010551507"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23179587"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102017\u201006\u2010743252"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25544"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060\u2010017\u20102400\u20105"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30089"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552\u2010012\u20109943\u20108"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40615\u2010019\u201000602\u2010y"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26264"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34206"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21788"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1089\/heq.2017.0001"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023\u2010064088"},{"key":"e_1_2_8_41_1","first-page":"200","article-title":"The Role of Health Policy in Improving Health Outcomes and Health Equity","volume":"134","author":"Maddox K. E. J.","year":"2024","journal-title":"Transactions of the American Clinical and Climatological Association"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2007.01557.x"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.32049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T12:49:07Z","timestamp":1765975747000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.32049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,14]]},"references-count":41,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/pbc.32049"],"URL":"https:\/\/doi.org\/10.1002\/pbc.32049","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"type":"print","value":"1545-5009"},{"type":"electronic","value":"1545-5017"}],"subject":[],"published":{"date-parts":[[2025,9,14]]},"assertion":[{"value":"2025-05-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e32049"}}