Racial and Ethnic Disparities Observed in B-Cell ALL Outcomes

By Kerri Fitzgerald - Last Updated: February 24, 2023

Racial and ethnic outcomes disparities persist for B-cell acute lymphocytic leukemia (ALL); however, a study did not observe the same trend for T-cell ALL.

The study included patients aged 30 years and younger with newly diagnosed ALL in inpatient and outpatient centers in the United States, Canada, Australia, and New Zealand who had race or ethnicity data available and were enrolled in 8 completed Children’s Oncology Group trials.

Between January 1, 2004, and December 31, 2019, 24,979 patients were enrolled, of which 21,152 had race or ethnicity data available. More than half of patients (n=11,849; 56%) were male. Race and ethnicity were categorized as non-Hispanic White (n=13,872; 65.6%), Hispanic (n=4354; 20.6%), non-Hispanic Black (n=1517; 7.2%), non-Hispanic Asian (n=1071; 5.1%), and non-Hispanic other (n=338; 1.6%).

Five-year event-free survival (EFS) was:

  • 4% among non-Hispanic White patients
  • 8% among Hispanic patients (hazard ratio [HR], 1.37; 95% CI, 1.26-1.49; P<.0001)
  • 8% among non-Hispanic Black patients (HR, 1.45; 95% CI, 1.28-1.65; P<.0001)
  • 1% among Non-Hispanic Asian patients (95% CI, 85.5-90.3)
  • 8% non-Hispanic other patients (95% CI, 76.4-87.6)

Inferior EFS among Hispanic patients was substantially affected by disease prognosticators and insurance status, while the increased risk among non-Hispanic Black patients was minimally attenuated.

Five-year overall survival (OS) was:

  • 6% in non-Hispanic Asian patients (95% CI, 91.5-95.1)
  • 3% in non-Hispanic White patients (95% CI, 92.8-93.7)
  • 9% in Hispanic patients (95% CI, 88.7-90.9)
  • 7% in non-Hispanic Black patients (95% CI, 87.6-91.4)
  • 9% in non-Hispanic other patients (95% CI, 83.2-92.7)

The noted disparities appeared to only occur in patients with B-cell ALL, as no differences in EFS or OS were observed in patients with T-cell ALL.

Source: The Lancet Haematology

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