By Serena McNiff
The takeaways: where patients live and their access to quality health care is important. And even when black people with AML have the same access to treatment as white patients, their survival is shorter – which genetic differences could explain.
The authors of the two studies recently discussed their findings at an online press briefing hosted by the American Society of Hematology.
“There is important work to be done and important gaps to be filled,” said Dr. Chancellor Donald, assistant professor of medicine, hematology and medical oncology at Tulane University School of Medicine in New Orleans, who led the briefing.
For the first study, researchers analyzed the medical records of more than 800 people with AML in Chicago and found that black patients from disadvantaged communities had a 48% higher risk of dying from the disease than white patients.
Hispanic AML patients from inner city areas also have a 20% higher risk of death than white patients, the results showed.
Regardless of neighborhood inequalities, the gap in survival rates between black and white AML patients narrowed, suggesting that a patient’s zip code contributed to their chances of surviving cancer.
The researchers said there are many potential explanations for the geographic disparity.
According to Dr. Bhavana Bhatnagar, an Ohio State University (OSU) Cancer specialist and lead author of the second study, “Access can potentially be an issue, in terms of being able to reach tertiary care centers that have clinical test availability and physicians who have disease-specific expertise in the treatment of some of these rarer cancers. I think sometimes the location of these larger cancer centers can be a barrier to accessing care. “
Bhatnagar is a hematologist specializing in the treatment of AML at the OSU Comprehensive Cancer Center in Columbus.
In the second study, his team analyzed a national cancer database. He found that young black patients with AML are 27% more likely to die from the disease than younger white patients. Typically, younger patients have a greater opportunity for recovery, Bhatnagar said.
But even when patients of both races received the same treatments, the outcomes of black patients were worse, clinical test data shown.
“Even if they have the same access to treatment and the same rates of discount“Black patients have a significantly shorter survival time than white patients,” Bhatnagar said.
The researchers said the genetic analysis revealed differences in the cancer cells of black and white patients with AML.
Doctors now know that if a patient’s leukemia cells have certain genetic mutations, their chances of survival are generally better. But black patients were less likely to carry these mutations, and when they did, they didn’t produce the same favorable results as white patients, the results showed.
While treatment options and survival rates for AML patients as a whole have improved over time, the gap between the survival outcomes of black and white patients has actually widened, the researchers said. researchers.
The study found that being black is, in and of itself, a risk factor for worse AML outcomes.
“We have shown that, yes, these survival disparities exist,” Bhatnagar said. “Enrollment in clinical trials does not reduce these disparities, and there are underlying genetic differences that do not necessarily portray the same prognostic value in young black AML patients as in the general AML population.
Moderator Donald praised the authors for digging in and getting closer to identifying some of the reasons for health inequalities.
“Race and ethnicity, among other factors, affect all facets of a person’s life,” he said. “If we are to tackle health disparities, we need to identify where they exist. This requires denouncing the various structures likely to propagate these problems.
To learn more about acute myeloid leukemia, visit American Cancer Society.
SOURCE: American Society of Hematology, press briefing, December 4, 2020