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Cited by 89Acute Lymphoblastic Leukemia researchGlobal Cancer Incidence and ScreeningHealth disparities and outcomes

Racial/ethnic and socioeconomic disparities in survival among children with acute lymphoblastic leukemia in California, 1988-2011: A population-based observational study: Survival Disparities in Childhood Leukemia by Race

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Abrahão, Renata, Lichtensztajn, Daphne Y., Ribeiro, Raul C., Marina, Neyssa M., Keogh, Ruth H., Marcos-Gragera, Rafael, Glaser, Sally L., Keegan, Theresa H.M.·2015·Pediatric Blood & Cancer
DOI 10.1002/pbc.25544PMC PMC9458416
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Abstract

BACKGROUND: Despite advances in treatment, survival from acute lymphoblastic leukemia (ALL) remains lower among non-White children than White children in the US. We investigated the association of race/ethnicity and socioeconomic status (SES) with survival. PROCEDURES: We analyzed 9,295 Californian children (3,251 Whites, 4,890 Hispanics, 796 Asians, and 358 Blacks) aged ≤ 19 years diagnosed with a first primary ALL during 1988-2011. We used the Kaplan-Meier method to estimate survival at 1, 5, and 10 years after diagnosis for three calendar periods. Hazard ratios of death for race/ethnicity, SES, and clinical factors were estimated by Cox regression models. RESULTS: Median follow-up time was 7.4 years (range 0-25 years). Over time, survival after ALL improved steadily, but inequalities persisted across races/ethnicities. Five-year survival (95% confidence interval) was 85.0% (83.6-86.2) for White, 81.4% (78.3-84.0) for Asian, 79.0% (77.8-80.2) for Hispanic, and 74.4% (69.4-78.8) for Black children. In multivariable-adjusted models, the hazard of death was increased by 57% among Black, 38% among Hispanic, and 33% among Asian children compared with White children. Patients residing in the lowest SES neighborhoods at diagnosis had a 39% increased risk of death relative to those living in higher SES neighborhoods. CONCLUSION: Despite significant improvements in survival, non-White children and children residing in low SES neighborhoods experienced worse survival even after adjusting for potential confounders. Our findings highlight the need to capture specific information on disease biology, treatment, and treatment adherence to better understand the predictors of lower survival in minority and low SES groups.

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  • Ancestry is known to alter both pediatric ALL incidence and survival.

    “Similarly, ancestry, which is known to alter both pediatric ALL incidence and survival (Abrahão et al., 2015; Goggins & Lo, 2012; Linabery, Johnson, & Ross, 2012), is likely to also impact the risk and severity of late effects (Bhatia et al., 2002; Dores, Devesa, Curtis, Linet, & Morton, 2012; Lim, Bhatia, Robison, & Yang, 2014; Yang et al., 2010).”

    From Brain structure, working memory and response inhibition in childhood leukemia survivors (2017) · cites this paper as Abrahão et al., 2015

    The Introduction says inherited genetic predisposition may differ across racial/ethnic groups, and the Results report differences in survival among those groups. But the paper does not establish that ancestry itself alters both overall pediatric ALL incidence and survival: its incidence discussion is hedged, and its survival analysis identifies associations rather than an ancestry-specific causal effect. No page numbers are available in our copy. (LLM, conf=0.85)

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Authors
Abrahão, R., Lichtensztajn, D. Y., Ribeiro, R. C., Marina, N. M., Keogh, R. H., Marcos-Gragera, R., Glaser, S. L., & Keegan, T. H. M.
Affiliations
  • Cancer Prevention Institute of California (US)
  • St. Jude Children's Research Hospital (US)
  • Lucile Packard Children's Hospital (US)
  • London School of Hygiene & Tropical Medicine (GB)
  • Epidemiology Unity and Cancer Registry of Girona; Institute for Biomedical Research of Girona; Girona Spain
Corresponding author
Abrahão, Renata
ORCID
Venue
Pediatric Blood & Cancer
Publisher
Wiley
Published
2015-04-20
Volume
62
Issue
10
Pages
1819-1825
ISSN
1545-5009 (ISSN-L)
DOI
10.1002/pbc.25544
PMC
PMC9458416
OpenAlex
W2106236192
Cited by
89
References
31
Citations by year
2026: 6 · 2025: 10 · 2024: 9 · 2023: 1 · 2022: 7 · 2021: 12 · 2020: 8 · 2019: 7 · 2018: 8 · 2017: 8 · 2016: 9 · 2015: 3
FWCI
10.01
Type
journal article
Language
en
Open access
Licence
Locations
  • Pediatric Blood & Cancer (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
Funders
  • Children with Cancer UK
  • Cancer Center Support (CORE), National Institutes of Health P30 (CA021765-30)
  • American Lebanese Syrian Associated Charities
  • Stanford Cancer Institute
  • California Department of Public Health (U58DP003862-01)
  • California Health and Safety Code Section (103885)
  • Surveillance, Epidemiology, and End Results
  • National Cancer Institute (HHSN261201000140C)
  • Cancer Prevention Institute (N01-PC-35136)
  • Public Health Institute (N02-PC-15105, U55/CCR921930-02, HHSN261201000034C)
  • University of Southern California (HHSN261201000035C)
  • Disease Control and Prevention's National Program
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Acute Lymphoblastic Leukemia research
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Social Sciences › Health › Health disparities and outcomes
Keywords
acute lymphoblastic leukemia, childhood cancer survival, racial disparities, ethnic disparities, socioeconomic status, health disparities, Black children, Hispanic children, Asian children, low-income communities, California
MeSH terms
Adolescent, California, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Socioeconomic Factors, Kaplan-Meier Estimate, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Healthcare Disparities, Young Adult

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