Evolving racial/ethnic disparities in AML survival in the novel therapy era
Abstract: Little is known about the impact of recent advances in acute myeloid leukemia (AML) treatment on racial/ethnic disparities in survival outcomes. We performed a retrospective cohort study of patients with newly diagnosed AML using data from a nationwide electronic health record–derived deid...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-02-01
|
| Series: | Blood Advances |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2473952924006712 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832576383305383936 |
|---|---|
| author | Xin Wang Phyllis A. Gimotty Andrew H. Matthews Ronac Mamtani Selina M. Luger Elizabeth O. Hexner Daria V. Babushok Shannon R. McCurdy Noelle V. Frey Ximena Jordan Bruno Saar Gill Mary Ellen Martin Vikram R. Paralkar Ivan Maillard David L. Porter Alison W. Loren Alexander E. Perl Keith W. Pratz Kelly D. Getz Catherine Lai |
| author_facet | Xin Wang Phyllis A. Gimotty Andrew H. Matthews Ronac Mamtani Selina M. Luger Elizabeth O. Hexner Daria V. Babushok Shannon R. McCurdy Noelle V. Frey Ximena Jordan Bruno Saar Gill Mary Ellen Martin Vikram R. Paralkar Ivan Maillard David L. Porter Alison W. Loren Alexander E. Perl Keith W. Pratz Kelly D. Getz Catherine Lai |
| author_sort | Xin Wang |
| collection | DOAJ |
| description | Abstract: Little is known about the impact of recent advances in acute myeloid leukemia (AML) treatment on racial/ethnic disparities in survival outcomes. We performed a retrospective cohort study of patients with newly diagnosed AML using data from a nationwide electronic health record–derived deidentified database. Patients were categorized based on their diagnosis date relative to venetoclax approval, as pre–novel therapy era (Pre era; 2014-2018; n = 2998) or post–novel therapy era (Post era; 2019-2022; n = 2098). Patients in the Post era were older and had more comorbidities than Pre era. Non-Hispanic Black (NHB) and Hispanic patients were younger and more likely to have lower socioeconomic status than non-Hispanic White (NHW) patients, with no differences in the distributions of key disease features. After accounting for age and comorbidity, overall survival (OS) was higher in patients in Post era than Pre era (adjusted hazard ratio [aHR], 0.90; 95% confidence interval [CI], 0.83-0.96). In Pre era, NHB had a 22% higher hazard of death than NHW (aHR, 1.22; 95% CI, 1.04-1.43), whereas worse OS was not observed for NHB in Post era (aHR, 0.86; 95% CI, 0.69-1.08; predicted 2-year survival, 45.3% vs 39.9%). Utilization of novel therapeutics in frontline therapy did not differ by race/ethnicity. Among patients receiving venetoclax-based induction, particularly those without TP53, RAS, or FLT3-ITD mutations, results suggested higher OS for NHB than NHW patients (aHR, 0.67; 95% CI, 0.45-1.01). Additional studies are needed to elucidate factors contributing to these observed survival differences and to inform strategies to optimize outcomes for all patients with AML. |
| format | Article |
| id | doaj-art-033998285a0049908500e6c31b4f958c |
| institution | Kabale University |
| issn | 2473-9529 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Blood Advances |
| spelling | doaj-art-033998285a0049908500e6c31b4f958c2025-01-31T05:12:10ZengElsevierBlood Advances2473-95292025-02-0193533544Evolving racial/ethnic disparities in AML survival in the novel therapy eraXin Wang0Phyllis A. Gimotty1Andrew H. Matthews2Ronac Mamtani3Selina M. Luger4Elizabeth O. Hexner5Daria V. Babushok6Shannon R. McCurdy7Noelle V. Frey8Ximena Jordan Bruno9Saar Gill10Mary Ellen Martin11Vikram R. Paralkar12Ivan Maillard13David L. Porter14Alison W. Loren15Alexander E. Perl16Keith W. Pratz17Kelly D. Getz18Catherine Lai19Division of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA; Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Correspondence: Xin Wang, Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 530 E 74th St, New York, NY 10021;Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PADepartment of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Division of Oncology, Children’s Hospital of Philadelphia, Philadelphia, PADivision of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PAAbstract: Little is known about the impact of recent advances in acute myeloid leukemia (AML) treatment on racial/ethnic disparities in survival outcomes. We performed a retrospective cohort study of patients with newly diagnosed AML using data from a nationwide electronic health record–derived deidentified database. Patients were categorized based on their diagnosis date relative to venetoclax approval, as pre–novel therapy era (Pre era; 2014-2018; n = 2998) or post–novel therapy era (Post era; 2019-2022; n = 2098). Patients in the Post era were older and had more comorbidities than Pre era. Non-Hispanic Black (NHB) and Hispanic patients were younger and more likely to have lower socioeconomic status than non-Hispanic White (NHW) patients, with no differences in the distributions of key disease features. After accounting for age and comorbidity, overall survival (OS) was higher in patients in Post era than Pre era (adjusted hazard ratio [aHR], 0.90; 95% confidence interval [CI], 0.83-0.96). In Pre era, NHB had a 22% higher hazard of death than NHW (aHR, 1.22; 95% CI, 1.04-1.43), whereas worse OS was not observed for NHB in Post era (aHR, 0.86; 95% CI, 0.69-1.08; predicted 2-year survival, 45.3% vs 39.9%). Utilization of novel therapeutics in frontline therapy did not differ by race/ethnicity. Among patients receiving venetoclax-based induction, particularly those without TP53, RAS, or FLT3-ITD mutations, results suggested higher OS for NHB than NHW patients (aHR, 0.67; 95% CI, 0.45-1.01). Additional studies are needed to elucidate factors contributing to these observed survival differences and to inform strategies to optimize outcomes for all patients with AML.http://www.sciencedirect.com/science/article/pii/S2473952924006712 |
| spellingShingle | Xin Wang Phyllis A. Gimotty Andrew H. Matthews Ronac Mamtani Selina M. Luger Elizabeth O. Hexner Daria V. Babushok Shannon R. McCurdy Noelle V. Frey Ximena Jordan Bruno Saar Gill Mary Ellen Martin Vikram R. Paralkar Ivan Maillard David L. Porter Alison W. Loren Alexander E. Perl Keith W. Pratz Kelly D. Getz Catherine Lai Evolving racial/ethnic disparities in AML survival in the novel therapy era Blood Advances |
| title | Evolving racial/ethnic disparities in AML survival in the novel therapy era |
| title_full | Evolving racial/ethnic disparities in AML survival in the novel therapy era |
| title_fullStr | Evolving racial/ethnic disparities in AML survival in the novel therapy era |
| title_full_unstemmed | Evolving racial/ethnic disparities in AML survival in the novel therapy era |
| title_short | Evolving racial/ethnic disparities in AML survival in the novel therapy era |
| title_sort | evolving racial ethnic disparities in aml survival in the novel therapy era |
| url | http://www.sciencedirect.com/science/article/pii/S2473952924006712 |
| work_keys_str_mv | AT xinwang evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT phyllisagimotty evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT andrewhmatthews evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT ronacmamtani evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT selinamluger evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT elizabethohexner evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT dariavbabushok evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT shannonrmccurdy evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT noellevfrey evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT ximenajordanbruno evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT saargill evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT maryellenmartin evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT vikramrparalkar evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT ivanmaillard evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT davidlporter evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT alisonwloren evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT alexandereperl evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT keithwpratz evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT kellydgetz evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera AT catherinelai evolvingracialethnicdisparitiesinamlsurvivalinthenoveltherapyera |