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Survival Inferior in Black Patients With Acute Myeloid Leukemia

Most disparities in acute myeloid leukemia mortality death accounted for by census tract measures

WEDNESDAY, March 23, 2022 (HealthDay News) — For patients with acute myeloid leukemia (AML), non-Hispanic Black individuals have inferior survival to non-Hispanic White individuals, with census tract measures accounting for most of the disparities in survival, according to a study recently published in Blood.

Ivy Elizabeth Abraham, M.D., from UChicago Medicine Ingalls Memorial Hospital, and colleagues conducted a discrete survival analysis on 822 adults with AML from six urban cancer centers. The contribution of neighborhood measures of structural racism on racial/ethnic differences in survival was examined. Mediation analysis of the risk of leukemia death between groups was examined across composite variables.

The researchers found that mortality was higher for non-Hispanic Black and Hispanic patients versus non-Hispanic White patients. For leukemia death, nearly all of the disparities between non-Hispanic Black and non-Hispanic White and Hispanic and non-Hispanic White patients were accounted for by census tract measures. Additional mediators of survival disparities were treatment patterns, including induction intensity and allogeneic transplant, as well as treatment complications, as assessed by intensive care unit admission during induction chemotherapy.

“We focus our energies on tailoring therapies to the patient’s physical health, as well as the molecular characteristics of the leukemia,” a coauthor said in a statement. “But no one’s really paid attention to the third piece in that Venn diagram, which is the social determinants of health, both individual as well as the neighborhood, which represents the continuum of their experiences.”

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