Mortality Up for Children With Leukemia From Lowest SES Neighborhoods
THURSDAY, Aug. 28, 2025 -- Children with acute lymphoblastic leukemia (ALL) from the lowest socioeconomic status (SES) neighborhoods have an increased risk for mortality, according to a study published online Aug. 22 in Blood Advances.
Anna L. Hoppmann, M.D., M.P.H., from the University of South Carolina School of Medicine in Columbia, and colleagues used the National Cancer Database to examine the impact of area-level SES on overall survival among children with ALL in a retrospective cohort study. A composite area-level SES variable was created using median income and education quartiles based on residential zip code.
The cohort included 17,044 children with ALL (57 percent male; 61 percent non-Hispanic White). Overall, 12 and 18 percent resided in the lowest and highest SES neighborhoods, respectively. The researchers found that children in the lowest SES neighborhoods had a 55 percent increased hazard of all-cause mortality compared with those in the highest SES neighborhoods. Among those from the lowest SES neighborhoods, the increased hazard of mortality persisted in those who survived two and five years (hazard ratios, 1.70 and 1.87, respectively).
"There has been increasing recognition of SES as a driver of persistent inequities within pediatric oncology and the need for ongoing efforts to address them," the authors write. "The present findings illustrate that area-level SES-associated vulnerabilities persist during off-therapy follow-up among children with ALL."
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