Family circumstances and survival from childhood acute lymphoblastic leukaemia in West Germany

• Findings suggest that family circumstances may affect survival from paediatric ALL.
• Those characteristics were birth order, number of siblings and parental age.
• This suggests that some families are in need of extra supportive care.
• More research needed to confirm these results and to identify underlying mechanisms.

BackgroundLittle is known about the relationship between family characteristics and survival from childhood acute lymphoblastic leukaemia (ALL), which we studied for the first time in German children.MethodsALL cases were diagnosed between 1992 and 1994 and information on family characteristics was collected during a previously conducted nationwide case–control study. Children were followed for 10 years after diagnosis, as few disease-related events occur afterwards. Cox proportional hazards models estimating hazard ratios (HR) were calculated using overall as well as event-free survival methods.ResultsSecond born children showed statistically significant better survival compared to first or later born children, with HRs ranging between 0.54 and 0.64 compared to firstborns. Somewhat poorer survival was observed for children having 3 or more siblings. A relationship was found for parental age at child's diagnosis, with poorer survival for children with younger parents (≤25 years of age at child's diagnosis), or with older fathers. The HR was statistically significant for fathers being ≥41years of age (HR of 2.1). No relationship between degree of urbanization of the place of residence at diagnosis and ALL survival was observed.ConclusionFamily circumstances may have an impact on survival from childhood ALL in Germany. Further research is warranted to elaborate the relationship of specific family characteristics and ALL survival and to investigate possible differential adherence to therapy and interactions with physicians.