Air pollution and mortality in acute lymphoblastic leukemia patients across different age groups in Northern Thailand (1999-2020).
In a 604-patient ALL cohort from northern Thailand, higher air-pollutant concentrations—particularly PM2.5 ≥50 µg/m³—were associated with mortality, with the clearest reported pollution-related signal in pediatric patients.
Open original publication →What the AI sees
In a 604-patient ALL cohort from northern Thailand, higher air-pollutant concentrations—particularly PM2.5 ≥50 µg/m³—were associated with mortality, with the clearest reported pollution-related signal in pediatric patients.
Research significance
The observational evidence supports air pollution as a possible prognostic or modifiable exposure in pediatric ALL; it can be inferred, but is not demonstrated here, that reducing exposure during treatment might improve outcomes or identify patients needing additional supportive measures.
Source abstract
This study investigated the impact of air pollution on 604 patients diagnosed with acute lymphoblastic leukemia (ALL) between 1999 and 2020 in upper northern Thailand. Patients were categorized into three age groups: pediatric (<15 years), adolescent and young adult (AYA) (15-39 years), and adult (≥40 years). The cohort included 344 (57.0%) pediatric, 152 (25.1%) AYA, and 108 (17.9%) adult patients, with 5-year survival rates of 64.5%, 19.6%, and 6.7%, respectively. Concentrations of PM2.5, PM10, O₃, and CO were significantly higher in patients who died, particularly among pediatric cases. Among AYA patients, those who died had higher levels of PM2.5, PM10, and CO than survivors. Compared to the pediatric group, the risk of death was higher in AYA (adjusted hazard ratio [aHR]: 3.76) and adult (aHR: 8.10) groups. Patients diagnosed before 2010 had an increased risk of death (aHR: 1.38). Notably, PM2.5 levels ≥50 µg/m³ were associated with increased mortality in pediatric patients. These findings highlight the adverse effects of air pollution on survival outcomes in ALL patients, particularly children under 15 years of age.