Disparities in receiving disease‐directed therapy, allogeneic stem cell transplantation in non‐Hispanic Black patients with TP53‐mutated acute myeloid leukemia. Issue 6 (21st December 2022)

• Record Type: Journal Article
• Authors: Badar, Talha; Litzow, Mark R.; Shallis, Rory M.; Patel, Anand; Saliba, Antoine N.; Burkart, Madelyn; Bewersdorf, Jan P.; Stahl, Maximilian; De Camargo Correia, Guilherme Sacchi; Guru Murthy, Guru Subramanian; Abaza, Yasmin; Duvall, Adam; Bradshaw, Danielle; Kota, Vamsi; Dinner, Shira; Goldberg, Aaron D.; Palmisiano, Neil; Al Kali, Aref; Atallah, Ehab
• Is Part Of: Cancer. Volume 129:Issue 6(2023)
• Page Start: 934
• Page End: 945
• Publication Date: 2022-12-21
• Subjects: acute myeloid leukemia (AML) -- allogeneic hematopoietic stem cell transplantation (allo‐HSCT) -- disparities in leukemia -- structural racism -- TP53mutation; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.34604
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract: Background: Although the clinical outcomes of patients with TP53‐ mutated acute myeloid leukemia (AML) are dismal, subsets of patients eligible for curative‐intent therapies may fare better. Because racial disparities are known to affect outcome in hematologic malignancies, the authors sought to explore disparities among patients with TP53 ‐mutated AML. Methods: A multicenter, retrospective study was conducted in a cohort of 340 patients who had TP53 ‐mutated AML (275 non‐Hispanic White [NHW] and 65 non‐Hispanic Black [NHB]) to analyze differences in treatment and outcome among NHW and NHB patients. Results: The median patient age was comparable between NHW and NHB patients ( p = .76). A higher proportion of NHB patients had therapy‐related AML (31% vs. 20%; p = .08) and had co‐mutations (74% vs. 61%; p = .06). A higher proportion of NHW patients received intensive chemotherapy compared with NHB patients (47% vs. 31%; p = .02). Conversely, a higher proportion of NHB patients received low‐intensity chemotherapy (9% vs. 5.5%; p = .02) or best supportive care (22% vs. 7%; p < .001). The complete response rate (including complete responses with or without complete count recovery) was 31% versus 24.5% ( p = .39) in NHW and NHB patients, respectively. Only 5% of NHB patients received allogeneic stem cell transplantation compared with 15.5% of NHW patients ( p = .02). The proportion of patients who were event‐free (18.5% vs. 8.5%; p = .49) or who remained alive (24.9% vs. 8.3%; p = .13) at 18 months was numerically higher in NHW versus NHB patients, respectively, but was not statistically significant. Conclusions: The current study highlights disparities between NHW and NHB patients with TP53 ‐mutated AML. Efforts are warranted to eliminate treatment disparities in minority populations. Abstract : Non‐Hispanic Black patients with TP53 ‐mutated acute myeloid leukemia (AML) were more likely to have concurrent mutations and therapy‐related AML than non‐Hispanic White patients. Non‐Hispanic Black patients who had TP53 ‐mutated AML received disease‐directed therapies less often compared with non‐Hispanic White patients.