Race/Ethnicity and Survival Outcomes in Younger Patients With AML
Posted: Monday, December 6, 2021
Racial-ethnic disparities in survival outcomes among pediatric patients with acute myeloid leukemia (AML) appear to differ across cytogenetic subclasses. Rachel E. Rau, MD, of Baylor College of Medicine, and colleagues found that the prognosis of prevalence, survival rates, and overall outcomes in AML among patients of Black and Hispanic ethnicities were worse than those of White non-Hispanic patients. A detailed report of the study was published in the journal Blood Advances.
“These findings suggest that, while variables such as availability of transplant donors likely contribute to outcome disparities in pediatric AML, underlying biology predisposing patients to more severe disease phenotype may also contribute,” said the authors.
The study used the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database to determine the association of race-ethnicity with leukemia cytogenetics, clinical features, and survival outcomes within major cytogenetic subgroups of pediatric AML. Of the 843 patients enrolled in the study, 552 were White non-Hispanic, 154 were Hispanic, and 108 were Black non-Hispanic. The median age at diagnosis was 10.1 years, and the median time under observation was 4.5 years.
KMT2AR-rearranged AML was less common among Hispanic patients than White non-Hispanic patients, but it was a worse prognosis for Black patients. Across the enrolled patients, presenting phenotypic features of AML did not differ by race-ethnicity, including age, white blood cell count, myeloblast percentage, central nervous system disease, and presence of chloromas. Black patients were found to be at a higher risk of death (hazard ratio = 1.97), with an overall survival rate of 52%, compared with 63% among Hispanic patients and 71% among White non-Hispanic patients. In addition, Black patients were twice as likely to have high-risk genetic features –5/5q- or –7/7q– and also more than five times as likely to have the KMT2A rearrangement than non-Black patients.
Disclosure: The study authors reported no conflicts of interest.