Clinical and Epidemiological Characteristics of Infants <6 Months With Leukemia, Neuroblastoma, and Retinoblastoma in a Single Center in Iran.

BACKGROUND: Malignancies in infants younger than 6 months differ from those in older children in incidence, clinical presentation, treatment response, and outcomes. Limited data exist on these infants' survival, particularly in low- and middle-income countries. PROCEDURE: We retrospectively analyzed the data of 153 infants (<6 mo) with diagnosed retinoblastoma (n=116), neuroblastoma (n=20), or leukemia (n=17) at MAHAK Pediatric Cancer Treatment and Research Center (2007 to 2021). Demographics, disease characteristics, family history, treatment, and survival outcomes were collected. Overall survival (OS) was estimated by using the Kaplan-Meier method, and prognostic factors were evaluated using the Mantel-Cox log-rank testing. RESULTS: Retinoblastoma was the most common diagnosis, with 67.8% of retinoblastoma cases being bilateral. Various stages and subtypes of neuroblastoma and leukemia were present. Family history of cancer was positive in 53.8% of patients. Most patients with neuroblastoma or retinoblastoma experienced remission; however, those with leukemia experienced high mortality (14/17). Diagnosis significantly predicted survival (RR for leukemia: 4, 95% CI: 0.43-4.19, P<0.001). Thus, the 5-year OS rate was 79.1% overall but was 14.7% for leukemia, 86% for retinoblastoma, and 100% for neuroblastoma. CONCLUSIONS: Infants younger than 6 months with leukemia, retinoblastoma, or neuroblastoma show distinct clinical patterns and have differing survival rates. Neuroblastoma and retinoblastoma have favorable outcomes, whereas leukemia carries a poor prognosis. Early recognition, tailored therapy, and follow-up are essential.