Cited by 270Acute Lymphoblastic Leukemia researchGlobal Cancer Incidence and ScreeningLymphoma Diagnosis and Treatment

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Racial and ethnic differences in survival of children with acute lymphoblastic leukemia

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Bhatia, Smita, Sather, Harland N., Heerema, Nyla A., Trigg, Michael E., Gaynon, Paul S., Robison, Leslie L.·2002·Blood

DOI 10.1182/blood-2002-02-0395

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Abstract

Black children with acute lymphoblastic leukemia (ALL) have poor outcomes, but limited information is available for children from other racial and ethnic backgrounds, such as Hispanic and Asian. We undertook a retrospective cohort study of children with ALL treated on Children's Cancer Group therapeutic protocols to determine outcomes by racial and ethnic backgrounds of patients treated with contemporary risk-based therapy. In total, 8447 children (white, n = 6703; Hispanic, n = 1071; black, n = 506; and Asian, n = 167) with newly diagnosed ALL between 1983 and 1995 were observed for a median of 6.5 years. Analysis of disease outcome was measured as overall survival (OS) and event-free survival (EFS) and was adjusted for known predictors of outcome including clinical features, disease biology, socioeconomic status, and treatment era (1983-1989 vs 1989-1995). There was a statistically significant difference in survival by ethnicity (P < .001). Five-year EFS rates were: Asian, 75.1% ± 3.5%; white, 72.8% ± 0.6%; Hispanic, 65.9% ± 1.5%; and black, 61.5% ± 2.2%. Multivariate analysis revealed that when compared with white children, black and Hispanic children had worse outcomes and Asian children had better outcomes after adjusting for known risk factors. The poorer outcomes among black children were most apparent among patients with standard-risk features (relative risk [RR], 2.0; 95% confidence interval [CI], 1.6-2.5), whereas poorer outcomes in Hispanic children (RR, 1.4; 95% CI, 1.2-1.6) were most evident among patients with high-risk features. Asian children had better outcomes than all racial and ethnic groups among high-risk patients, particularly in the recent era (5-year EFS, 90.9% ± 6.1%). Racial and ethnic differences in OS and EFS persist among children with ALL who receive contemporary risk-based therapy. Future studies should focus on reasons—perhaps compliance or pharmacogenetics—for those differences.

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Authors: Bhatia, S., Sather, H. N., Heerema, N. A., Trigg, M. E., Gaynon, P. S., & Robison, L. L.
Affiliations: University of Southern California (US)
Corresponding author: Bhatia, Smita
ORCID: Bhatia, Smita
Gaynon, Paul S.
Robison, Leslie L.
Venue: Blood
Publisher: American Society of Hematology
Published: 2002-09-15
Volume: 100
Issue: 6
Pages: 1957-1964
ISSN: 0006-4971 (ISSN-L)
1528-0020
DOI: 10.1182/blood-2002-02-0395
OpenAlex: W1995246501
Cited by: 270
References: 47
Citations by year: 2026: 6 · 2025: 8 · 2024: 9 · 2023: 11 · 2022: 15 · 2021: 14 · 2020: 25 · 2019: 12 · 2018: 11 · 2017: 12 · 2016: 13 · 2015: 12 · 2014: 18 · 2013: 10 · 2012: 17
FWCI: 8.68
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Blood (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
National Cancer Institute (U10CA013539, 5U10 CA 13539-2652)
Topics: Health Sciences › Medicine › Hematology › Acute Lymphoblastic Leukemia research
Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
Keywords: acute lymphoblastic leukemia, racial disparities, ethnic differences, children, overall survival, event-free survival, Hispanic children, Black children, Asian children, socioeconomic status, pharmacogenetics, medication adherence
MeSH terms: Adolescent, Child, Child, Preschool, Chromosome Aberrations, Ethnicity, Female, Follow-Up Studies, Humans, Infant, Male, Prospective Studies, Retrospective Studies, Risk Factors, Social Class, Survival Analysis, Treatment Outcome, Disease-Free Survival, Racial Groups, Precursor Cell Lymphoblastic Leukemia-Lymphoma

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Racial and ethnic differences in survival of children with acute lymphoblastic leukemia

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