Background: Disparities in solid tumors have been well studied. However disparities in hematologic malignancies in adults remain relatively unexplored. The purpose of this study is to explore the relationship between race/ethnicity and mortality from acute leukemia among adults.

Methods: All patients with acute leukemia (Acute Lymphoblastic Leukemia (ALL) and Acute Myelogenous Leukemia (AML)) were identified in the Surveillance Epidemiology and End Results (SEER) database, 1998–2008. Kaplan Meier curves were generated to reflect mortality by race/ethnicity. Multivariable Cox proportional hazard models estimated hazard of mortality by race with adjustment for individual covariates (age, gender) and specific chromosomal translocations (11q23 and 15;17q24;q21).

Results: A total of 40,951 patients with acute leukemia were included in the study. Overall, there was a disparity in mortality in acute leukemia for Blacks (HR 1.17, p<0.0001) and Hispanics (HR 1.12, p<0.0001) compared with Non-Hispanic Whites (NHW). In stratified analysis, disparities in ALL were greater than AML; Blacks (HR[ALL]1.45 p<.0001; HR[AML]1.12 p<0.0001); Hispanics (HR[ALL]1.46 p<0.0001; HR[AML]1.06 p<0.01). Adjustment for individual patient factors and chromosomal translocations do not explain the disparities in ALL or AML. There was no disparity among Asian/Pacific Islander populations compared with NHW.

Conclusions: Overall, disparities in acute leukemia mortality exist for Blacks and Hispanics compared with NHWs. While incidence and mortality are consistently increased among Hispanics with acute leukemia, Blacks suffer from a low incidence but higher mortality paradox as is seen in other solid tumors such as breast cancer. Further investigation is needed to understand the drivers of poor outcomes in these populations.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A82.

Copyright © September 18, 2011, American Association for Cancer Research
2011