Specific and Non-specific Clinical Presentations in the Year Before the Diagnosis of Childhood Leukaemia

Tien Yu Owen Yang, Yen Lin Liu, Wan Ting Huang, Mei Huei Chen, Pau Chung Chen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Clinical presentations of childhood leukaemia have been reported in case-only studies. The timing when these presentations start to occur prior to diagnosis is less clear. Methods: In this nested case–control study, 1,025 and 334 children with lymphoid and myeloid leukaemia, respectively, were matched (1:30) to population-based controls by sex, region and year of birth. An index date was assigned for each control when the matched case was diagnosed. Healthcare access records of cases and controls in the year before the index date were extracted. Results: Children with lymphoid leukaemia started to visit doctors more often at least 2 months before leukaemia diagnosis (P < 0.05). Various presentations were recorded in these visits: rates of haematological presentations, musculoskeletal presentations, and injuries started to increase significantly at least 3 months before diagnosis; rates of respiratory, gastrointestinal and urinary tract presentations did not increase significantly until the last month. The findings for myeloid lymphoma were less clear, but children appeared to visit doctors more often at least 4 months before diagnosis, and the rate of haematological presentations also started to increase at least 4 months before leukaemia diagnosis. Although haematological presentations were most strongly associated with undiagnosed leukaemia (odds ratio > 290 in the last month), the majority (>96%) of children with haematological presentations did not have leukaemia if they had not been diagnosed in their first visit. Conclusions: We described a clinical picture in the year before leukaemia diagnosis. These findings revealed ongoing difficulties in early diagnosis of childhood leukaemia in healthcare settings.

Original languageEnglish
Pages (from-to)1387-1393
Number of pages7
JournalPediatric Blood and Cancer
Volume63
Issue number8
DOIs
Publication statusPublished - Aug 1 2016

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Leukemia
Lymphoid Leukemia
Delivery of Health Care
Myeloid Leukemia
Population Control
Early Diagnosis
Parturition

Keywords

  • cancer screening
  • childhood leukaemia
  • early diagnosis
  • electronic health record
  • epidemiology
  • personalised medicine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)
  • Hematology
  • Oncology

Cite this

Specific and Non-specific Clinical Presentations in the Year Before the Diagnosis of Childhood Leukaemia. / Yang, Tien Yu Owen; Liu, Yen Lin; Huang, Wan Ting; Chen, Mei Huei; Chen, Pau Chung.

In: Pediatric Blood and Cancer, Vol. 63, No. 8, 01.08.2016, p. 1387-1393.

Research output: Contribution to journalArticle

Yang, Tien Yu Owen ; Liu, Yen Lin ; Huang, Wan Ting ; Chen, Mei Huei ; Chen, Pau Chung. / Specific and Non-specific Clinical Presentations in the Year Before the Diagnosis of Childhood Leukaemia. In: Pediatric Blood and Cancer. 2016 ; Vol. 63, No. 8. pp. 1387-1393.
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