Clinical and Epidemiological Characteristics of Infants <6 Months With Leukemia, Neuroblastoma, and Retinoblastoma in a Single Center in Iran.
This retrospective single-center Iranian cohort of 153 infants younger than 6 months reports markedly different five-year overall survival by cancer type, with particularly poor survival among the 17 infants with leukemia compared with those with retinoblastoma or neuroblastoma.
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This retrospective single-center Iranian cohort of 153 infants younger than 6 months reports markedly different five-year overall survival by cancer type, with particularly poor survival among the 17 infants with leukemia compared with those with retinoblastoma or neuroblastoma.
Research significance
The observed high mortality in infant leukemia provides evidence for a clinically important high-risk subgroup; it can be hypothesized, but was not tested here, that earlier recognition, leukemia-specific risk stratification, and adapted supportive or therapeutic protocols could improve outcomes.
Source abstract
BACKGROUND: Malignancies in infants younger than 6 months differ from those in older children in incidence, clinical presentation, treatment response, and outcomes. Limited data exist on these infants' survival, particularly in low- and middle-income countries. PROCEDURE: We retrospectively analyzed the data of 153 infants (<6 mo) with diagnosed retinoblastoma (n=116), neuroblastoma (n=20), or leukemia (n=17) at MAHAK Pediatric Cancer Treatment and Research Center (2007 to 2021). Demographics, disease characteristics, family history, treatment, and survival outcomes were collected. Overall survival (OS) was estimated by using the Kaplan-Meier method, and prognostic factors were evaluated using the Mantel-Cox log-rank testing. RESULTS: Retinoblastoma was the most common diagnosis, with 67.8% of retinoblastoma cases being bilateral. Various stages and subtypes of neuroblastoma and leukemia were present. Family history of cancer was positive in 53.8% of patients. Most patients with neuroblastoma or retinoblastoma experienced remission; however, those with leukemia experienced high mortality (14/17). Diagnosis significantly predicted survival (RR for leukemia: 4, 95% CI: 0.43-4.19, P<0.001). Thus, the 5-year OS rate was 79.1% overall but was 14.7% for leukemia, 86% for retinoblastoma, and 100% for neuroblastoma. CONCLUSIONS: Infants younger than 6 months with leukemia, retinoblastoma, or neuroblastoma show distinct clinical patterns and have differing survival rates. Neuroblastoma and retinoblastoma have favorable outcomes, whereas leukemia carries a poor prognosis. Early recognition, tailored therapy, and follow-up are essential.