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Patients with acute myelogenous leukemia (AML) from a socially disadvantaged environment show poorer therapeutic outcome

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Abstract

Aim

Socioeconomic position (SEP) has a significant influence on the clinical course of several diseases. For acute myelogenous leukemia (AML), only limited data on the association between SEP and Overall Survival (OS) are available.

Subject and methods

In this retrospective study, we divided the city of Aachen (approx. 250,000 inhabitants) into areas with middle/high as opposed to low socioeconomic background using the official social development plan. Using these data, the outcome of 135 AML-patients who were treated at the RWTH Aachen University Hospital, was analyzed.

Results

No significant differences in the distribution of established prognostic factors could be detected between the two SEP areas. For patients who received treatment with curative intention, we found a significantly impaired OS for those living in low compared to middle/high SEP areas (15.9 vs 28.8 months, p = 0.02). Furthermore, achievement of complete remission was significantly lower among those from low versus middle/high SEP areas (39.1 % vs. 73.0 %, p = 0.01), which is of particular interest given the fact that this study was performed in a health care system with obligatory health insurance.

Conclusion

These data provide the basis for a detailed investigation on underlying mechanisms by which SEP affects AML survival and prognosis. Strategies to prevent this unsatisfactory situation need to be addressed.

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Acknowledgements

We would like to thank all patients in observational studies.

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Author notes

    Authors and Affiliations

    1. Department of Hematology, Oncology, Hemostaseology and Stem cell transplantation, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

      Andrea Kaifie, Edgar Jost, Tim H Brümmendorf, Stefan Wilop & Martina Crysandt

    2. Institute of Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

      Andrea Kaifie

    3. Centre for Health and Society, Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany

      Thorsten Lunau & Nico Dragano

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    1. Andrea Kaifie
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    2. Thorsten Lunau
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    3. Nico Dragano
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    4. Edgar Jost
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    5. Tim H Brümmendorf
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    Correspondence to Andrea Kaifie.

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    Andrea Kaifie declares that she has no conflict of interest.

    Thorsten Lunau declares that he has no conflict of interest.

    Nico Dragano declares that he has no conflict of interest.

    Edgar Jost declares that he has no conflict of interest.

    Tim H. Brümmendorf declares that he has no conflict of interest.

    Stefan Wilop declares that he has no conflict of interest.

    Martina Crysandt declares that she has no conflict of interest.

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    This study had no funding.

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    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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    For this type of study, formal consent is not required.

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    Stefan Wilop and Martina Crysandt contributed equally to this work.

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    Kaifie, A., Lunau, T., Dragano, N. et al. Patients with acute myelogenous leukemia (AML) from a socially disadvantaged environment show poorer therapeutic outcome. J Public Health 25, 187–195 (2017). https://doi.org/10.1007/s10389-016-0767-y

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    • DOI: https://doi.org/10.1007/s10389-016-0767-y

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