Ethnicity and survival in childhood acute myeloid leukemia: a report from the Children's Oncology Group.
We evaluated differences in outcome by ethnicity among children with acute myeloid leukemia (AML). We analyzed 791 children in the CCG 2891 trial and confirmed positive findings in 850 children in the CCG 2961 trial. Hispanic and black children treated with chemotherapy in CCG 2891 had significantly inferior overall survival (OS) from study entry compared with white children (37%+/- 9% vs 48%+/- 4% [P = .016] and 34% +/- 10% vs 48% +/- 4%, [P = .007], respectively). Significantly fewer black children had related donors. Analyses of CCG 2961 confirmed that black children had significantly decreased OS rates compared with white children (45% +/- 12% vs 60% +/- 4%; P = .007) The difference in OS rates between Hispanic and white children approached statistical significance (51% +/- 8% vs 60% +/- 4%; P = .065) Only 7.5% of black children on CCG 2961 had an available family donor. In conclusion, Hispanic and black children with AML have worse survival than white children. Access to chemotherapy, differences in supportive care or leukemia phenotype, and reduced compliance are unlikely explanations for this difference because therapy was given intravenously according to CCG protocols. Fewer black children than expected had an available family marrow donor.
Pediatric Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA. raplenc@cceb.med.upenn.edu
Richard
R
Aplenc
Todd A
TA
Alonzo
Robert B
RB
Gerbing
Franklin O
FO
Smith
Soheil
S
Meshinchi
Julie A
JA
Ross
John
J
Perentesis
William G
WG
Woods
Beverly J
BJ
Lange
Stella M
SM
Davies
D000208:Acute Disease; D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D017326:Clinical Trials, Phase III as Topic / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007951:Leukemia, Myeloid / Q000208:ethnology* / Q000401:mortality* / Q000628:therapy; D008297:Male; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012074:Remission Induction; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American