TABLE III.
Unadjusted and Multivariable-Adjusted Hazard Ratios and 95% Confidence Intervals for Overall Survival in Children (0–19 Years Old) With Acute Lymphoblastic Leukemia in California.
| Covariates | Death N (%) | Unadjusted HR1 (1988–2011) (95%CI) | Adjusted HR2 (1988–2011) (95%CI) | Adjusted HR3 (1996–2011) (95%CI) | Adjusted HR4 (1996–2011) (95%CI) |
|---|---|---|---|---|---|
| Race/ethnicity | |||||
| White | 568 (29.1) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| Black | 100 (5.1) | 1.78 (1.44–2.20) | 1.57 (1.26–1.96) | 1.74 (1.31–2.31) | 1.72 (1.29–2.28) |
| Hispanic | 1,123 (57.4) | 1.47 (1.33–1.62) | 1.38 (1.23–1.55) | 1.43 (1.22–1.68) | 1.37 (1.17–1.62) |
| Asian | 164 (8.4) | 1.26 (1.06–1.50) | 1.33 (1.12–1.59) | 1.42 (1.13–1.79) | 1.40 (1.11–1.76) |
| Gender | |||||
| Male | 1,237 (63.3) | 1.27 (1.16–1.39) | 1.19 (1.09–1.31) | 1.20 (1.06–1.35) | 1.19 (1.06–1.35) |
| Female | 718 (36.7) | 1.0 (Reference) | 1.0 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| Socioeconomic status | |||||
| 1.Lowest 20% | 623 (32.3) | 1.61 (1.39–1.87) | 1.39 (1.18–1.64) | 1.40 (1.12–1.75) | 1.30 (1.04–2.27) |
| 2. | 414 (21.2) | 1.29 (1.10–1.51) | 1.15 (0.97–1.35) | 1.20 (0.95–1.51) | 1.15 (0.91–1.44) |
| 3. | 339 (17.3) | 1.20 (1.02–1.41) | 1.13 (0.95–1.33) | 1.10 (0.87–1.38) | 1.06 (0.84–1.34) |
| 4. | 324 (16.6) | 1.23 (1.04–1.45) | 1.17 (0.99–1.39) | 1.22 (0.97–1.54) | 1.20 (0.95–1.51) |
| 5. Highest 20% | 246 (12.6) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| Calendar period | |||||
| 1988–1995 | 781 (39.9) | 1.66 (1.47–1.87) | 1.97 (1.74–2.24) | N/A | N/A |
| 1996–2003 | 744 (38.1) | 1.38 (1.22–1.56) | 1.50 (1.33–1.70) | 1.52 (1.34–1.73) | 1.50 (1.33–1.71) |
| 2004–2011 | 430 (22.0) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| Treatment at a pediatric cancer center | |||||
| No | 724 (37.0) | 1.35 (1.23–1.48) | 1.06 (0.96–1.16) | 1.05 (0.92–1.19) | 1.05 (0.92–1.19) |
| Yes | 1,231 (63.0) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| Type of health insurance: model limited to cases diagnosed from 1996 onwards (N = 6638) | |||||
| No insurance | 29 (2.5) | 1.54 (1.06–2.23) | N/A | N/A | 1.22 (0.83–1.89) |
| Private insurance | 583 (49.6) | 1.00 (Reference) | N/A | N/A | 1.00 (Reference) |
| Public insurance | 487 (41.5) | 1.31 (1.16–1.47) | N/A | N/A | 1.15 (1.01–1.32) |
| Unknown | 75 (6.4) | 2.31 (1.82–2.94) | N/A | N/A | 1.77 (1.38–2.26) |
HR, hazard ratio; CI, confidence interval; NOS, not otherwise specified. The multivariable models were adjusted for all variables presented in the table and stratified by age, immunophenotype and secondary neoplasm. HR1, unadjusted model; Hr2, adjusted model without insurance, 1988–2011; Hr3, adjusted model without insurance, 1996–2011; Hr4, adjusted model with insurance, 1996–2011.