(HealthDay News) — Among children receiving maintenance treatment for acute lymphoblastic leukemia (ALL), those living in extreme poverty have an increased risk of relapse, according to a study published in Blood.

Researchers examined the association between individual-level poverty and relapse among 592 children receiving maintenance treatment for ALL. Overall, 12.3% of patients were living in extreme poverty (120% below federal poverty thresholds).

The median follow-up was 7.9 years. The cumulative incidence of relapse at 3 years was significantly higher among patients living in extreme poverty than among patients not living in extreme poverty (14.3% and 7.6%, respectively; P =.04).

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In a multivariable analysis, patients living in extreme poverty had a nearly 2-fold higher risk of relapse (hazard ratio [HR], 1.95; 95% CI, 1.03-3.72, P =.04). However, including race/ethnicity in the analysis mitigated this association (HR, 1.68; 95% CI, 0.86-3.28, P =.1).

Patients living in extreme poverty were more likely than other patients to be non-adherent to mercaptopurine (57.1% and 40.9%, respectively; P =.04). The researchers noted, however, that poor adherence did not completely explain the association between poverty and relapse risk.

One researcher is a medical director at Servier Pharmaceuticals.

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