scholarly journals How Do Differences in Treatment Impact Racial and Ethnic Disparities in Acute Myeloid Leukemia?

2015 ◽  
Vol 24 (2) ◽  
pp. 344-349 ◽  
Author(s):  
Manali I. Patel ◽  
Yifei Ma ◽  
Beverly Mitchell ◽  
Kim F. Rhoads
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Ethnic Disparities ◽  
Racial And Ethnic Disparities ◽  
Acute Myeloid

Ethnic Disparities In Acute Myeloid Leukemia Survival In The United States

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1691-1691
Author(s):  
Binay K. Shah ◽  
Amir Bista ◽  
Bahman Shafii
Keyword(s):  
Acute Myeloid Leukemia ◽  
Native American ◽  
Myeloid Leukemia ◽  
Ethnic Disparities ◽  
Patient Characteristics ◽  
The United States ◽  
Recent Time ◽  
Gradual Improvement ◽  
Time Period ◽  
Acute Myeloid

Abstract Background There is scarcity of data on differences in survival in acute myeloid leukemia (AML) patients by ethnicity. We utilized data from the Surveillance Epidemiology and End Result (SEER) database to investigate the ethnic disparities of survival in general U.S. population. Methods The SEER-18 Registry was used to identify adult (>=18) patients with AML as the only or the first primary cancer diagnosed from 1992 to 2010. We only included cases which were microscopically confirmed and actively followed. Cases that were alive without survival time, those resulted in death certificate/autopsy, and those with ethnicity recorded as unknown were excluded from this study. A total of 29,477 patients (54.5% males) were identified. For the subsequent analyses, various cohorts were formed. Age group cohorts included: 18-44 (5394; 18.3%), 45-54 (3751; 12.7%), 55-64 (4913; 16.7%), 65-74 (6513; 22.1%) and 75+ (8906; 30.2%). The total study period was divided into four groups, 1992-1995 (3409; 11.6%), 1996-2000 (5816; 19.7%), 2001-2005 (9984; 33.9%) and 2006-2010 (10268; 34.8%) for the survival analyses over time. Ethnic stratification used included White (21338; 72.4%), African American (AA: 2322; 7.9%), Asians/Pacific Islanders (A/PI: 2389; 8.1%), Native American/Alaskan Natives (NA/AN: 137; 0.5%) and Hispanics (3291; 11.2%). NA/AN categories were excluded from the final analysis due to their small numbers. Kaplan Meier (KM) curve and log rank test were used to evaluate association between patient characteristics and survival in overall population, OS, and AML-specific survival(AMLSS). Cox proportional hazards model was used for the analysis of association between patient characteristics and survival. Statistical analyses were carried out using SPSS version 16.0.0 Results Median age at diagnosis for the patient population was 66 years. Median follow-up period was 6.17 years for the whole population. Median OS for whole population was 6 months with highest survival among Hispanics and lowest among Whites (10 months versus 5 months, p <0.001). The AMLSS was highest for Hispanics and lowest for Whites (24 months versus 12 months, p <0.001). Median OS and AMLSS deteriorated significantly with advancing age (p<0.001). The median OS and AMLSS were the same for males and females (p>0.05), in overall population. OS for females were better than males among AA and Hispanic patients (p value <0.001). AMLS survival was better for A/PI females compared to males (median AMLSS 22 months vs. 17 months, p =0.015). When comparing survival among year of diagnosis cohorts, OS as well as AMLSS were comparable among 1992-1995 and 1996-2000 cohorts, (p>0.05); however, there was a gradual improvement in the more recent time period cohorts. Results of the proportional hazard models indicated that when compared to Whites, the OS was best for A/PI and worst for AA patients (HR= 0.933, p= 0.006, and HR = 1.139, p <0.001 ,respectively). The OS was higher for females, younger patients, and for patients diagnosed during recent time period cohorts. Similarly, AMLS survival among Hispanics and AA was comparable to whites and, best for Asians/PI (HR 0.911, p =0.003). Conclusions This study demonstrated significant differences in survival rates among AML patients belonging to various ethnic groups with highest OS and AMLSS among A/PI AML patients. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Association of race and ethnicity with clinical phenotype, genetics, and survival in pediatric acute myeloid leukemia

2021 ◽  
Author(s):  
Shannon E. Conneely ◽  
Casey L McAtee ◽  
Rohit Gupta ◽  
Joseph Lubega ◽  
Michael E. Scheurer ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Race And Ethnicity ◽  
Myeloid Leukemia ◽  
Ethnic Disparities ◽  
Gemtuzumab Ozogamicin ◽  
Survival Outcomes ◽  
Black Patients ◽  
Hispanic Patients ◽  
Pediatric Aml ◽  
Acute Myeloid

Black and Hispanic children with acute myeloid leukemia (AML) have worse outcomes compared to White children. AML is a heterogeneous disease with numerous genetic subtypes in which these disparities have not been specifically investigated. In this study, we used the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database to examine the association of race-ethnicity with leukemia cytogenetics, clinical features, and survival outcomes within major cytogenetic subgroups of pediatric AML. Compared to White non-Hispanic patients, t(8;21) AML was more prevalent among Black (OR, 2.22; 95% CI, 1.28-3.74) and Hispanic patients (OR, 1.74; 95% CI, 1.05-2.83). The poor prognosis KMT2A rearrangement t(6;11)(q27;q23) was more prevalent among Black patients (OR, 6.12; 95% CI, 1.81-21.59). Among those with KMT2Ar AML, Black race was associated with inferior event-free survival (EFS) (HR, 2.31; 95% CI, 1.41-3.79) and overall survival (OS) (HR, 2.54; 1.43-4.51). Hispanic patients with KMT2Ar AML also had inferior EFS (HR, 2.20; 95% CI, 1.27-3.80) and OS (HR, 2.07; 95% CI, 1.09-3.93). Similarly, among patients with t(8;21) or inv(16) AML (i.e., core binding factor AML), Black patients had inferior outcomes (EFS HR, 1.93; 95% CI, 1.14-3.28 and OS HR, 3.24; 95% CI, 1.60-6.57). This disparity was not detected among patients receiving gemtuzumab ozogamicin. In conclusion, racial-ethnic disparities in survival outcomes among young people with AML are prominent and vary across cytogenetic subclasses. Future studies should explore the socioeconomic and biologic determinants of these disparities.

Racial and ethnic enrollment disparities in acute myeloid leukemia clinical trials.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6523-6523
Author(s):  
Andrew Hantel ◽  
Daniel J. DeAngelo ◽  
Marlise Rachael Luskin ◽  
Jacqueline Suen Garcia ◽  
Gregory A. Abel
Keyword(s):  
Clinical Trials ◽  
Acute Myeloid Leukemia ◽  
Race And Ethnicity ◽  
Myeloid Leukemia ◽  
Ethnic Disparities ◽  
Hispanic Patients ◽  
Incident Cases ◽  
Over Time ◽  
Acute Myeloid ◽  
White Patients

6523 Background: Racial and ethnic disparities in clinical trial enrollment compound inequities in drug development and the delivery of patient-centered care. Despite significant survival disparities in acute myeloid leukemia (AML), enrollment disparities data are limited. Methods: We performed a structured search and abstraction of demographic data for all United States (US) AML clinical trials from 2002-2017 listed on clinicaltrials.gov and compared the results to the incidence and demographic distribution of AML using the Surveillance, Epidemiology, and End Results program and 2010 US Census. We calculated enrollment fractions (the number of enrollees divided by the number of incident cases) for the five mutually exclusive race/ethnicity groups of non-Hispanic White (NH-White), Black (NH-Black), Asian/Pacific Islander (NH-Asian/PI), American Indian/Native Alaskan (NH-AI/AN), and Hispanic patients. We compared these using X2 testing, with NH-White as the comparator, and reported odds ratios with 95% confidence intervals (CI). To assess trends over time, we adjusted enrollment from 2005-2008 for changes in AML incidence and NH-White enrollment for a later period (2011-2014), comparing this expected enrollment fraction to the actual enrollment fraction during that later period. Results: Of 223 eligible studies (patient N=17372) on clinicaltrials.gov, 99 (44.4%) reported racial demographics (N=8417; 48.5%) and 68 (30.5%) reported race and ethnicity (N=6554; 37.7%). Enrollment and incidence proportions by race are shown in the table. Among trials reporting race and ethnicity, all groups had lower odds of enrollment compared to NH-White patients (Table). For the 99 trials reporting race data, Black and AI/AN patient enrollment odds were lower (OR 0.60 [95% CI: 0.55, 0.65]; 0.50 [95% CI: 0.33, 0.76]), but Asian/PI enrollment was not (OR 0.91 [95% CI: 0.82, 1.01]). The relative enrollment of NH-Black, NH-Asian/PI, and Hispanic patients declined later in the study period (Table). Conclusions: In AML clinical trials performed in the US from 2002-2017, NH-White patients were enrolled at higher rates compared to other racial and ethnic groups; enrollment diversity declined over time. An important first step to reducing enrollment disparities will be to improve the reporting of demographic enrollment data.[Table: see text]

Increased Risk of Severe Sepsis in Hispanic Children Hospitalized With Acute Myeloid Leukemia

2020 ◽  
Vol 37 (6) ◽  
pp. 349-358
Author(s):  
Beth Savage ◽  
Charlotte Thomas-Hawkins ◽  
Peter D. Cole ◽  
Jerod L. Stapleton ◽  
Pamela B. de Cordova
Keyword(s):  
Acute Myeloid Leukemia ◽  
Severe Sepsis ◽  
Myeloid Leukemia ◽  
Intensive Therapy ◽  
Secondary Analysis ◽  
Ethnic Disparities ◽  
The United States ◽  
Hispanic Children ◽  
Increased Risk ◽  
Acute Myeloid

The purpose of this study, a secondary analysis of a publicly available database, was to identify racial and ethnic disparities in the risk of severe sepsis facing children undergoing the intensive therapy necessary to treat acute myeloid leukemia (AML). The sample consisted of 1,913 hospitalizations of children, younger than 21 years, in the United States during the year 2016 with documentation of both AML and at least one infectious complication. Binary logistic regression models were used to examine the association between race/ethnicity and severe sepsis in children with AML and infection. We found that, after controlling for potential confounding variables, the odds of developing severe sepsis were significantly increased for Hispanic children compared with White children. There were no significant differences in the likelihood of the development of sepsis in Black, Asian, or other race children. The increased risk of severe sepsis for Hispanic children may contribute to the disparate rates of overall survival in this group. This inequitable rate of severe sepsis was evident despite the generally accepted practice of retaining children in the hospital throughout recovery of blood counts following AML therapy. Nurses are in a position to identify and eliminate modifiable risk factors contributing to this disparity.

Ethnic disparities relative to disease features and outcomes in children with acute myeloid leukemia

2017 ◽  
Vol 64 (9) ◽  
pp. e26487 ◽  
Author(s):  
M. Monica Gramatges ◽  
Aditya Deshpande ◽  
Philip J. Lupo ◽  
Rachel E. Rau ◽  
Michele L. Redell ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Ethnic Disparities ◽  
Acute Myeloid
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