Association of race and ethnicity with clinical phenotype, genetics, and survival in pediatric acute myeloid leukemia
Open accessAbstract
Black and Hispanic children with acute myeloid leukemia (AML) have worse outcomes compared with White children. AML is a heterogeneous disease with numerous genetic subtypes in which these disparities have not been specifically investigated. In this study, we used the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database to examine the association of race-ethnicity with leukemia cytogenetics, clinical features, and survival outcomes within major cytogenetic subgroups of pediatric AML. 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 KMT2A rearrangement t(6;11)(q27;q23) was more prevalent among Black patients (OR, 6.12; 95% CI, 1.81-21.59). 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; 1.43-4.51). 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). Similarly, among patients with t(8;21) or inv(16) AML (ie, core-binding factor [CBF] AML), Black patients had inferior outcomes (EFS HR, 1.93; 95% CI, 1.14-3.28 and OS HR, 3.24; 95% CI, 1.60-6.57). This disparity was not detected among patients receiving gemtuzumab ozogamicin (GO). 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.
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Significant racial and ethnic disparities in the incidence and survival of hematologic malignancies have been documented.
“Significant racial and ethnic disparities in the incidence and survival of hematologic malignancies have also been documented [51,52].”
From Race and ethnicity: Risk factors for fungal infections? (2023) · cites this paper as [52]
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- Authors
- Conneely, S. E., McAtee, C. L., Gupta, R., Lubega, J., Scheurer, M. E., & Rau, R. E.
- Affiliations
- Baylor College of Medicine (US)
- Corresponding author
- Rau, Rachel E.
- ORCID
- Venue
- Blood Advances
- Publisher
- American Society of Hematology
- Published
- 2021-12-02
- Volume
- 5
- Issue
- 23
- Pages
- 4992-5001
- ISSN
- 2473-9529 (ISSN-L)
- 2473-9537
- PMC
- PMC9153027
- OpenAlex
- W3204190284
- Cited by
- 31
- References
- 31
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 9 · 2023: 5 · 2022: 1
- FWCI
- 2.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Blood Advances (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Cancer Institute (R01CA183252)
- Topics
- Health Sciences › Medicine › Hematology › Acute Myeloid Leukemia Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Acute Lymphoblastic Leukemia research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinoids in leukemia and cellular processes
- Keywords
- pediatric acute myeloid leukemia, racial and ethnic disparities, Black children, Hispanic children, MLL rearrangement, core binding factor AML, cytogenetic subgroups, event-free survival, overall survival, gemtuzumab ozogamicin, TARGET database, pediatric oncology
- MeSH terms
- Adolescent, Ethnicity, Hispanic or Latino, Humans, Phenotype, Leukemia, Myeloid, Acute, Proportional Hazards Models
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