Racial and ethnic disparities in Acute Myeloid Leukemia: 15-year experience at a safety net hospital system

Despite recent therapeutic advances, ethnic minorities in the U.S. continue to have disproportionately poor outcomes in many hematologic malignancies including AML. We identified 162 adult AML patients treated at a non-transplant safety net hospital from 2007 to 2022 and evaluated differences in dis...

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Bibliographic Details
Published in:Leukemia research 2024-06, Vol.141, p.107503, Article 107503
Main Authors: Dong, Sharlene, Premnath, Naveen, Sadeghi, Navid, Kainthla, Radhika, Chung, Stephen S., Collins, Robert H., Li, Hsiao C., Madanat, Yazan F.
Format: Article
Language:English
Subjects:
Acute Myeloid Leukemia
Adolescent
Adult
Aged
Ethnicity - statistics & numerical data
Female
Healthcare Disparities
Hematopoietic stem cell transplant
Hispanic or Latino - statistics & numerical data
Humans
Leukemia, Myeloid, Acute - ethnology
Leukemia, Myeloid, Acute - mortality
Leukemia, Myeloid, Acute - therapy
Male
Middle Aged
Outcomes
Retrospective Studies
Safety net hospital
Safety-net Providers
Survival
Survival Rate
Young Adult
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Summary:Despite recent therapeutic advances, ethnic minorities in the U.S. continue to have disproportionately poor outcomes in many hematologic malignancies including AML. We identified 162 adult AML patients treated at a non-transplant safety net hospital from 2007 to 2022 and evaluated differences in disease characteristics, treatment and clinical outcomes based on race and ethnicity. Our cohort consisted of 82 (50.6%) Hispanic, 36 (22.2%) non-Hispanic black and 44 (27.2%) non-Hispanic white and Asian patients. Median age at diagnosis was 42.5, 49.0 and 52.5 years respectively (p=0.025). Hispanics had higher rates of intermediate and high-risk disease (p=0.699) and received high intensity induction and consolidation chemotherapy at lower rates (p=0.962), although differences did not reach statistical significance. Despite this, similar remission rates were achieved. Hispanics with high-risk disease had longer overall survival (OS) than the combined non-Hispanic cohort (mOS 14 m vs 7 m, p=0.030). Multivariate regression analysis showed that OS was negatively associated with age (HR 1.023, p=0.006), intermediate (HR 3.431, p=0.0003) and high-risk disease (HR 4.689, p
ISSN:0145-2126
1873-5835
1873-5835
DOI:10.1016/j.leukres.2024.107503