Although survival outcomes for children and young adults with acute lymphocytic leukemia (ALL) have improved significantly over the last several decades, there are still significant disparities in outcomes based on race and ethnicity, according to a new study published in The Lancet Haematology.
The study examined more than 21,000 participants in Children’s Oncology Group trials from 2004 to 2019 to investigate whether racial disparities persist and if they can be attributed to differences in leukemia biology or insurance status.
The study findings showed that the 5-year event-free survival (EFS) rate, which measures how long patients survived without experiencing a leukemia-related event, was higher among White patients (87.4%) and Hispanic patients (82.8%) compared with Black patients (81.8%).
Furthermore, the study revealed that Asian and White patients have a higher survival rate than Hispanic and Black patients. Specifically, the 5-year overall survival (OS) rates were higher among Asian patients (93.6%) and White patients (93.3%) compared with Hispanic patients (89.9%) and Black patients (89.7%).
The researchers also considered factors such as insurance status and disease predictors and found that adjusting for those factors reduced the increased risk of an event among Hispanic patients but only minimally attenuated the risk among Black patients. According to the authors, this finding suggests that, especially in Black children, something is happening in addition to those factors.
The researchers noted that the greater disparities observed in OS compared with EFS suggest that these disparities could be more pronounced in the context of relapsed disease rather than newly diagnosed disease. “Hence, access to or quality of treatments for relapsed disease are important,” they wrote.
“Future research elucidating the mechanisms underlying these disparities should include studies of access to and quality of care, particularly during maintenance therapy and among relapsed patients,” the researchers concluded.
Source: MedPage Today
