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Impact of race on outcomes in intermediate-risk acute myeloid leukemia

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Abstract

Purpose

Racial disparities in acute myeloid leukemia (AML) have been reported but the relative contribution of disease versus patient-specific factors including comorbidities and access to care is unclear.

Methods

We conducted a retrospective analysis of patient characteristics, treatment patterns and outcomes in a racially diverse patient cohort controlling for cytogenetic risk group. Patients were classified into four groups: non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic and Other.

Results

We evaluated 106 patients from 84 zipcodes incorporating demographics, clinicopathologic features, treatment patterns and outcomes. We identified significant differences in BMI and geographic poverty based on ethnoracial group, while prognostic mutations in NPM1 and FLT3 did not differ significantly. Utilization of intensive chemotherapy and transplant rate did not differ by ethnoracial group. However, there was a significantly higher use of alternate donor transplants in minority populations. There was a notably increased rate of clinical trial enrollment in NHW patients compared to other groups. In log-rank analysis, NHW patients had increased overall survival (OS) compared to NHB, Hispanic and Other patients (31.6 months vs. 16.7 months vs. 14.3 months, vs 18.1 months, p = 0.021). In bivariate analysis, overall survival was negatively influenced by advanced age and race. Obesity and zip code poverty levels approached statistical significance in predicting OS. In multivariate analysis, the only factors independently influencing OS were race and allogeneic stem cell transplant.

Conclusion

These results suggest that race impacts survival in intermediate-risk AML, highlighting the need to dissect biologic and nonbiologic factors that contribute to this disparity.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

University of Illinois at Chicago Cancer Center Pilot Grant awarded to Dr. Irum Kha.

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Authors and Affiliations

  1. Division of Hematology and Oncology, Department of Internal Medicine, University of Illinois at Chicago, 840 South Wood Street, Ste 820 E-CSB, Chicago, IL, 60612, USA

    Ivy Elizabeth Abraham, John Patrick Galvin & Irum Khan

  2. University of Chicago Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA

    Anand Ashwin Patel

  3. Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA

    Heidy Wang & Li Liu

  4. Hematology and Oncology Division, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Olga Frankfurt

Authors
  1. Ivy Elizabeth Abraham
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  2. Anand Ashwin Patel
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  3. Heidy Wang
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  4. John Patrick Galvin
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  6. Li Liu
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  7. Irum Khan
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Correspondence to Irum Khan.

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Abraham, I.E., Patel, A.A., Wang, H. et al. Impact of race on outcomes in intermediate-risk acute myeloid leukemia. Cancer Causes Control 32, 705–712 (2021). https://doi.org/10.1007/s10552-021-01422-4

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  • DOI: https://doi.org/10.1007/s10552-021-01422-4

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