학술논문
Racial and ethnic disparities in childhood and young adult acute lymphocytic leukaemia: secondary analyses of eight Childrens Oncology Group cohort trials.
Document Type
article
Author
Teachey, David; Bona, Kira; Aplenc, Richard; Rabin, Karen; Zweidler-McKay, Patrick; Carroll, Andrew; Heerema, Nyla; Gastier-Foster, Julie; Borowitz, Michael; Wood, Brent; Maloney, Kelly; Mattano, Leonard; Larsen, Eric; Angiolillo, Anne; Burke, Michael; Salzer, Wanda; Winter, Stuart; Brown, Patrick; Guest, Erin; Dunsmore, Kimberley; Kairalla, John; Winick, Naomi; Carroll, William; Raetz, Elizabeth; Hunger, Stephen; Loh, Mignon; Devidas, Meenakshi; Gupta, Sumit; Dai, Yunfeng; Chen, Zhiguo; Winestone, Lena
Source
The Lancet Haematology. 10(2)
Subject
Language
Abstract
BACKGROUND: Previous studies have identified racial and ethnic disparities in childhood acute lymphocytic leukaemia survival. We aimed to establish whether disparities persist in contemporaneous cohorts and, if present, are attributable to differences in leukaemia biology or insurance status. METHODS: Patients with newly diagnosed acute lymphocytic leukaemia in inpatient and outpatient centres in the USA, Canada, Australia, and New Zealand, aged 0-30 years, who had race or ethnicity data available, enrolled on eight completed Childrens Oncology Group trials (NCT00103285, NCT00075725, NCT00408005, NCT01190930, NCT02883049, NCT02112916, NCT02828358, and NCT00557193) were included in this secondary analysis. Race and ethnicity were categorised as non-Hispanic White, Hispanic, non-Hispanic Black, non-Hispanic Asian, and non-Hispanic other. Event-free survival and overall survival were compared across race and ethnicity groups. The relative contribution of clinical and biological disease prognosticators and insurance status was examined through multivariable regression models, both among the entire cohort and among those with B-cell lineage versus T-cell lineage disease. FINDINGS: Between Jan 1, 2004, and Dec 31, 2019, 24 979 eligible children, adolescents, and young adults with acute lymphocytic leukaemia were enrolled, of which 21 152 had race or ethnicity data available. 11 849 (56·0%) were male and 9303 (44·0%) were female. Non-Hispanic White patients comprised the largest racial or ethnic group (13 872 [65·6%]), followed by Hispanic patients (4354 [20·6%]), non-Hispanic Black patients (1517 [7·2%]), non-Hispanic Asian (n=1071 [5·1%]), and non-Hispanic other (n=338 [1·6%]). 5-year event-free survival was 87·4% (95% CI 86·7-88·0%) among non-Hispanic White patients compared with 82·8% (81·4-84·1%; hazard ratio [HR] 1·37, 95% CI 1·26-1·49; p