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Race Matters Significantly in AML Outcomes, Study Data Show

By: Celeste L. Dixon
Posted: Monday, January 4, 2021

Being Black may be a critical patient-associated factor associated with poor survival in adults with acute myeloid leukemia (AML) younger than age 60, according to a study presented during the virtual edition of the 2020 American Society of Hematology (ASH) Annual Meeting and Exposition (Abstract 6). Bhavana Bhatnagar, DO, of The Ohio State University Comprehensive Cancer Center in Columbus, and colleagues explained that patients who self-reported their race as Black had a higher risk of death than those who were White (hazard ratio = 1.28), and their 3-year overall survival rates were 32% and 41%, respectively (P < .001).

Beyond age and race, the team took into account such factors as gender; income; and clinical, cytogenetic, and gene-mutation features. “Even when Black patients [with AML] have specific good prognostic risk factors, they had poorer outcomes,” noted Dr. Bhatnagar in an interview with The ASCO Post. “Black race by itself seems to be such a strong risk factor that it adds to the markers we usually rely on to risk-stratify patients.”

Utilizing the National Cancer Institute’s Surveillance, Epidemiology, and End Results database, the researchers studied 25,523 adults (18 years and older) diagnosed with AML between 1986 and 2015. They also examined data from the same years of 1,339 patients (7% Black and 93% White) all treated on Cancer and Leukemia Group B/Alliance for Clinical Trials in Oncology protocols. In the latter data set, Black patients had both inferior disease-free survival (median, 0.8 years vs. 1.4 years; P = .02) and overall survival (median, 1.2 years vs. 1.8 years; P = .02) compared with White patients.

The investigators’ conclusions took into account their discovery that Black patients who had NPM1-mutated AML—usually viewed as a factor favorably impacting survival—had outcomes less favorable than those of White patients with NPM1-mutated AML. What’s more, the Black patients with NPM1-mutated disease included those with no or low levels of FLT3-ITD, a feature also usually considered favorable.

Disclosure: The study authors’ disclosure information can be found at ash.confex.com.



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