Association of Race and Ethnicity with clinical Outcomes in Pediatric AML

Racial/ethnic disparities in survival outcomes among young people with acute myeloid leukemia (AML) are prominent, according to a study published in Blood Advances.

Black and Hispanic children with AML are known to have worse outcomes compared to White children; however, these disparities have not been specifically analyzed.

To conduct this study, researchers used the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database to assess the association of race/ethnicity with leukemia cytogenetics, clinical features, and survival outcomes within major cytogenetic subgroups of pediatric AML.

Following analysis, the results showed that compared with White non-Hispanic patients, t(8;21) AML was more prevalent among Black (odds ratio [OR] = 2.22, 95% confidence interval [CI] 1.28-3.74) and Hispanic patients (OR = 1.74, 95% CI 1.05-2.83). The poor prognosis of KMT2A AML was more prevalent among Black patients (OR = 6.12, 95% CI 1.81-21.59) than patients of other races/ethnicities. Among those with KMT2Ar AML, Black race was associated with inferior event-free survival (EFS; hazard ratio [HR] = 2.31, 95% CI 1.41-3.79), and overall survival (OS; HR = 2.54, 95% CI 1.43-4.51).

Similarly, the study found that Hispanic patients with KMT2Ar AML also had inferior EFS (HR = 2.20, 95% CI 1.27-3.80), and OS (HR = 2.07, 95% CI 1.09-3.93). The researchers observed that among patients with t(8;21) or inv(16) AML, Black patients had inferior outcomes (EFS HR = 1.93, 95% CI 1.14-3.28; OS HR= 3.24, 95% CI 1.60-6.57). They noted that this disparity was not detected among patients receiving gemtuzumab ozogamicin.

“In conclusion, racial-ethnic disparities in survival outcomes among young people with AML are prominent and vary across cytogenetic subclasses. Future studies should explore the socioeconomic and biologic determinants of these disparities,” the researchers concluded.