Racial and ethnic disparities in the survival of adolescents and young adults with acute myeloid leukemia: a retrospective study using the US National Cancer Data Base

Leuk Lymphoma. 2017 May;58(5):1184-1189. doi: 10.1080/10428194.2016.1231312. Epub 2016 Nov 3.

Abstract

Few studies have examined the effect of race on survival of adolescents and young adults (AYA) with acute myeloid leukemia. We studied patients in the US National Cancer Data Base aged 15-39 years diagnosed with AML from 2001 to 2011 (excluding acute promyelocytic leukemia). We examined overall survival (OS) according to race and determined OS trends over three time-periods: 2001-2004, 2005-2008, and 2009-2011. We identified 8684 patients, with a median follow-up of 62.8 months. Multivariable analysis showed that Blacks had a significantly worse (HR 1.21; 95%CI: 1.11-1.32) and Hispanics a significantly better OS (HR 0.90; 95%CI: 0.82-0.99) than Whites. OS improved over time among Whites only, with 1-year survival rates of 69, 72 and 74 months over the three time periods, respectively (p < .01). We found significant racial disparities in OS of AYA with AML. Further studies should examine clinician and patient care delivery factors that contribute to these disparities.

Keywords: Race; adolescent and young adult; disparity; leukemia; survival.

MeSH terms

  • Adolescent
  • Adult
  • Ethnicity / statistics & numerical data*
  • Female
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Incidence
  • Leukemia, Myeloid, Acute / epidemiology
  • Leukemia, Myeloid, Acute / mortality*
  • Male
  • Proportional Hazards Models
  • Retrospective Studies
  • Socioeconomic Factors
  • United States / epidemiology
  • Young Adult