{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:29:49Z","timestamp":1786645789966,"version":"build-2736575974"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fundamental Fund 2023, Chiang Mai University"},{"name":"Fundamental Fund 2023, Chiang Mai University"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    This study investigated the impact of air pollution on 604 patients diagnosed with acute lymphoblastic leukemia (ALL) between 1999 and 2020 in upper northern Thailand. Patients were categorized into three age groups: pediatric (&lt;15 years), adolescent and young adult (AYA) (15\u201339 years), and adult (\u226540 years). The cohort included 344 (57.0%) pediatric, 152 (25.1%) AYA, and 108 (17.9%) adult patients, with 5-year survival rates of 64.5%, 19.6%, and 6.7%, respectively. Concentrations of PM\n                    <jats:sub>2.5<\/jats:sub>\n                    , PM\n                    <jats:sub>10<\/jats:sub>\n                    , O\u2083, and CO were significantly higher in patients who died, particularly among pediatric cases. Among AYA patients, those who died had higher levels of PM\n                    <jats:sub>2.5<\/jats:sub>\n                    , PM\n                    <jats:sub>10<\/jats:sub>\n                    , and CO than survivors. Compared to the pediatric group, the risk of death was higher in AYA (adjusted hazard ratio [aHR]: 3.76) and adult (aHR: 8.10) groups. Patients diagnosed before 2010 had an increased risk of death (aHR: 1.38). Notably, PM\n                    <jats:sub>2.5<\/jats:sub>\n                    levels \u226550 \u00b5g\/m\u00b3 were associated with increased mortality in pediatric patients. These findings highlight the adverse effects of air pollution on survival outcomes in ALL patients, particularly children under 15 years of age.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0355856","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T17:37:26Z","timestamp":1786642646000},"page":"e0355856","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Air pollution and mortality in acute lymphoblastic leukemia patients across different age groups in Northern Thailand (1999\u20132020)"],"prefix":"10.1371","volume":"21","author":[{"given":"Patrinee","family":"Traisathit","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalita","family":"Sathitsamitphong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2731-4889","authenticated-orcid":true,"given":"Thanawat","family":"Rattanathammethee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1247-3131","authenticated-orcid":true,"given":"Pimwarat","family":"Srikummoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7121-0791","authenticated-orcid":true,"given":"Suttipong","family":"Kawilapat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natthapat","family":"Thongsak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawapon","family":"Nakharutai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7419-6171","authenticated-orcid":true,"given":"Salinee","family":"Thumronglaohapun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Titaporn","family":"Supasri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phonpat","family":"Hemwan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8552-0149","authenticated-orcid":true,"given":"Imjai","family":"Chitapanarux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"issue":"10230","key":"pone.0355856.ref001","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1016\/S0140-6736(19)33018-1","article-title":"Acute lymphoblastic leukaemia","volume":"395","author":"F Malard","year":"2020","journal-title":"Lancet"},{"issue":"11","key":"pone.0355856.ref002","first-page":"1627","article-title":"Acute lymphoblastic leukemia: an assessment of international incidence, survival, and disease burden","volume":"26","author":"AJ Katz","year":"2015","journal-title":"Cancer Causes Control"},{"key":"pone.0355856.ref003","article-title":"Acute lymphocytic leukemia","volume-title":"StatPearls","author":"Y Puckett","year":"2024"},{"issue":"6","key":"pone.0355856.ref004","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1002\/ajh.26156","article-title":"Acute lymphoblastic leukemia: a population-based study of outcome in the United States based on the surveillance, epidemiology, and end results (SEER) database, 1980-2017","volume":"96","author":"K Sasaki","year":"2021","journal-title":"Am J Hematol"},{"issue":"12","key":"pone.0355856.ref005","doi-asserted-by":"crossref","first-page":"5461","DOI":"10.1007\/s00277-024-06068-1","article-title":"Enhancing outcomes of childhood acute lymphoblastic leukemia in workplace diversity in Thailand: multicenter study on behalf of the Thai Pediatric Oncology Group","volume":"103","author":"C Monsereenusorn","year":"2024","journal-title":"Ann Hematol"},{"key":"pone.0355856.ref006","doi-asserted-by":"crossref","first-page":"106235","DOI":"10.1016\/j.leukres.2019.106235","article-title":"Better survivals in adolescent and Young adults, compared to adults with acute lymphoblastic leukemia - 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