SMALL INFLUENCE OF PARENTAL EDUCATIONAL-LEVEL ON THE SURVIVAL OF CHILDREN WITH LEUKEMIA IN THE NETHERLANDS BETWEEN 1973 AND 1979

We studied the effect of parental educational level (PEL), an indicato r of socio-economic status (SES), on survival of children with acute l ymphoblastic (ALL) and non-lymphoblastic leukaemia (ANLL). All childre n with ALL and ANLL diagnosed in The Netherlands in the period 1973-19 79, registered by the Dutch Childhood Leukaemia Study Group and follow ed until 1991 were included. Bone marrow and blood smears had been uni formly classified in a central laboratory; cases with acute lymphoblas tic leukaemia (ALL) were subdivided into standard risk (SR) and high r isk (HR). PEL, assessed as a risk indicator in a separately conducted population-based case-control study of the same children (response rat e: 88%), was divided into low, when neither of the parents had more th an elementary school or lower vocational education, and high when eith er had more. Children with SR ALL of high PEL parents had a slightly h igher 10-year survival rate than of low PEL parents (58% versus 54%, P = 0.25), whereas survival for the latter increased more (P = 0.06) fr om a lower level in the period 1973-1975. However, children of low PEL parents with HR ALL and ANLL had a higher 10-year survival rate compa red with children of high PEL parents (P = 0.10 and 0.22, respectively ). Children without information on PEL, non-responders, migrants and w ith missing values exhibited slightly worse survival rates. The influe nce of PEL on survival of acute leukaemia in children in The Netherlan ds during 1973-1979 appeared small or even equivocal. Small difference s in SES and optimal geographic and financial access to care, delivere d through national treatment protocols, may be responsible for these r esults.