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

Sharlene Dong, Naveen Premnath, Navid Sadeghi, Radhika Kainthla, Stephen S. Chung, Robert H. Collins, Hsiao C. Li, Yazan F. Madanat

Research output: Contribution to journalArticlepeer-review

Abstract

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<0.0001) and positively associated with Hispanic ethnicity (HR 0.614, p=0.026). This report suggests that contrary to other studies, Hispanics, particularly those with high-risk AML, may have improved OS compared to other ethnic groups. These results are unique to our safety net hospital setting where common barriers to medical care and healthcare disparities are largely mitigated.

Original languageEnglish (US)
Article number107503
JournalLeukemia Research
Volume141
DOIs
StatePublished - Jun 2024

Keywords

  • Acute Myeloid Leukemia
  • Healthcare disparities
  • Hematopoietic stem cell transplant
  • Outcomes
  • Safety net hospital
  • Survival

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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