TY - JOUR
T1 - Disparities in trial enrollment and outcomes of Hispanic adolescent and young adult acute lymphoblastic leukemia
AU - Muffly, Lori
AU - Yin, Jun
AU - Jacobson, Sawyer
AU - Wall, Anna
AU - Quiroz, Elisa
AU - Advani, Anjali S.
AU - Luger, Selina M.
AU - Tallman, Martin S.
AU - Litzow, Mark R.
AU - Foster, Matthew C.
AU - Erba, Harry P.
AU - Appelbaum, Frederick R.
AU - Larson, Richard A.
AU - Keegan, Theresa H.M.
AU - Stock, Wendy
N1 - Funding Information:
Conflict-of-interest disclosure: L.M. reports consultancy at Pfizer, Amgen, Jazz, Kite, Medexus, CTI Biopharma, and Astellas; research funding from Jasper, Kite, and Astellas; and honoraria from Adaptive. A.S.A. reports being on an advisory board at Glycomimetics, Amgen, Seattle Genetics, and Kite, and research funding from Glycomimetics, Abbvie, Macrogenics, Pfizer, Amgen, OBI, Immunogen, Seattle Genetics, and Kite. R.A.L. has acted as a consultant or advisor to Amgen, Ariad/Takeda, Astellas, Celgene/BMS, CVS/Care-mark, Epizyme, MorphoSys, Servier, and Novartis and has received clinical research support from Astellas, Celgene, Cellectis, Daiichi
Funding Information:
This work was supported by the National Cancer Institute of the National Institutes of Health under award numbers U10CA180821 and U10CA180882 (to the Alliance for Clinical Trials in Oncology).
Publisher Copyright:
© 2022 by The American Society of Hematology.
PY - 2022/7/26
Y1 - 2022/7/26
N2 - In this secondary analysis of Hispanic adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) treated on Cancer and Leukemia Group B (CALGB) 10403, we evaluated outcomes and geographic enrollment patterns relative to US population data. We used demographic, clinical, and survival data on AYAs enrolled on CALGB 10403 (N = 295, 2007-2012). Surveillance, Epidemiology, and End Results registries provided overall survival (OS) for US AYA ALL by ethnicity/race. North American Association of Cancer Registries provided AYA ALL incidence overall and proportion among Hispanics by US state. Of AYAs enrolled on CALGB 10403, 263 (89%) reported ethnicity/race: 45 (17%) Hispanic, 172 (65%) non-Hispanic White (NHW), 25 (10%) non-Hispanic Black (NHB), and 21 (8%) other. Compared with NHWs, Hispanic and NHB patients had lower household income, and Hispanic patients were more likely to harbor high-risk CRLF2 aberrations. Relative to US estimates, where Hispanic patients represented 46% of newly diagnosed AYA ALL patients and experienced inferior OS compared with NHW (P < .001), Hispanic AYAs on CALGB 10403 did as well as NHW patients (3 year OS, 75% vs 74%; P = NS). Hispanic patients also had higher rates of protocol completion (P = .05). Enrollments on CALGB 10403 differed relative to the distribution of Hispanic AYA ALL in the United States: enrollment was highest in the Midwest; t and only 15% of enrollees were from states with a high proportion of Hispanic AYA ALL patients. In summary, Hispanic patients treated on CALGB 10403 did as well as NHWs and better than population estimates. Geographical misalignment between trial sites and disease epidemiology may partially explain the lower-than-expected enrollment of Hispanic AYA ALL patients.
AB - In this secondary analysis of Hispanic adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) treated on Cancer and Leukemia Group B (CALGB) 10403, we evaluated outcomes and geographic enrollment patterns relative to US population data. We used demographic, clinical, and survival data on AYAs enrolled on CALGB 10403 (N = 295, 2007-2012). Surveillance, Epidemiology, and End Results registries provided overall survival (OS) for US AYA ALL by ethnicity/race. North American Association of Cancer Registries provided AYA ALL incidence overall and proportion among Hispanics by US state. Of AYAs enrolled on CALGB 10403, 263 (89%) reported ethnicity/race: 45 (17%) Hispanic, 172 (65%) non-Hispanic White (NHW), 25 (10%) non-Hispanic Black (NHB), and 21 (8%) other. Compared with NHWs, Hispanic and NHB patients had lower household income, and Hispanic patients were more likely to harbor high-risk CRLF2 aberrations. Relative to US estimates, where Hispanic patients represented 46% of newly diagnosed AYA ALL patients and experienced inferior OS compared with NHW (P < .001), Hispanic AYAs on CALGB 10403 did as well as NHW patients (3 year OS, 75% vs 74%; P = NS). Hispanic patients also had higher rates of protocol completion (P = .05). Enrollments on CALGB 10403 differed relative to the distribution of Hispanic AYA ALL in the United States: enrollment was highest in the Midwest; t and only 15% of enrollees were from states with a high proportion of Hispanic AYA ALL patients. In summary, Hispanic patients treated on CALGB 10403 did as well as NHWs and better than population estimates. Geographical misalignment between trial sites and disease epidemiology may partially explain the lower-than-expected enrollment of Hispanic AYA ALL patients.
UR - http://www.scopus.com/inward/record.url?scp=85134827191&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85134827191&partnerID=8YFLogxK
U2 - 10.1182/bloodadvances.2022007197
DO - 10.1182/bloodadvances.2022007197
M3 - Article
C2 - 35838753
AN - SCOPUS:85134827191
SN - 2473-9529
VL - 6
SP - 4085
EP - 4092
JO - Blood advances
JF - Blood advances
IS - 14
ER -
