fa تعیین عوامل موثر بر بقای کودکان مبتلا به لوسمی لنفوبلاستیک حاد با استفاده از مدل خطرات رقیب کارآزمایی بالینی Clinical Trials <p dir="RTL"></p> <p><strong><em>Background and Objective</em></strong><strong><em>:</em></strong> Acute lymphoblastic leukemia (ALL) is the most common malignancy in children, accounting for about a quarter of all malignancies. This study aimed to identify the prognosis of patients with relapsed acute lymphoblastic leukemia in Dr. Sheikh Hospital in Mashhad from 2006 to 2015 using competing risk models.</p> <p><strong><em>Materials and Methods:</em></strong> Patients with ALL from March 2006 to February 2015 were reviewed retrospectively, yielding 424 children with acute lymphoblastic leukemia. We considered the recurrence of cancer as a main event and death without recurrence as a competing risk. We employed Cox models and sub-distributions by univariate and multivariate analysis. Data analysis was performed using Stata and R softwares.</p> <p><strong><em>Results:</em></strong> The event free 5-year survival and the overall 5-year survival rates of all 424 patients were 70.2% and 81.9% respectively. The 5-year cumulative incident probability of recurrence and death prior to recurrence were 12 and 17 percent respectively. Based on the subdistribution models, white blood cells and blood platelets have been known to affect the recurrence of cancer.</p> <p><strong><em>Conclusion</em></strong><strong><em>:</em></strong> Our results showed that Cox and competing risk models have different results to determine the prognosis factors affecting leukemia patients&rsquo; survival despite the competing risks. Also subdistribution models reduce the duration of response to therapy and thus reduce the rate of mortality by providing significant health policies.</p> <p></p><p></p> Keywords: Acute lymphoblastic leukemia, Recurrence, Competing Risk, Cox, Subdistribution 123 136 http://journal.zums.ac.ir/browse.php?a_code=A-10-4-1018&slc_lang=fa&sid=1 Hossein Bonakchi حسین بنکچی 5200319475328460053361 5200319475328460053361 Yes Dept. of Biostatistics and Epidemiology, Faculty of Public Health, Mashhad University of Medical Sciences, Mashhad, Iran دانشگاه علوم پزشکی مشهد Hamid Farhangi حمید فرهنگی 5200319475328460053362 5200319475328460053362 No Dept. of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran دانشگاه علوم پزشکی مشهد Habibollah Esmaily حبیب الله اسماعیلی 5200319475328460053363 5200319475328460053363 No Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran دانشگاه علوم پزشکی مشهد Hassan Boosti حسن دوستی 5200319475328460053364 5200319475328460053364 No Dept. of Biostatistics and Epidemiology, Faculty of Public Health, Mashhad University of Medical Sciences, Mashhad, Iran دانشگاه علوم پزشکی مشهد Maryam Forouzannejhad مریم فروزان‌نژاد 5200319475328460053365 5200319475328460053365 No Dept. of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran دانشگاه علوم پزشکی مشهد