Disparities in Acute Lymphoblastic Leukemia Outcomes Not Present in Clinical Trials Among Hispanic Adolescents

By FYH News Team

Published on August 18, 2022

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In the CALGB 10403 trial of adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL), patients of Hispanic ethnicity demonstrated similar outcomes as patients who were non-Hispanic White, according to the results of a secondary analysis published in the journal Blood Advances.

These data are in contrast to US estimates, in which 46% of Hispanic patients with newly diagnosed ALL demonstrated shorter overall survival (OS) compared with non-Hispanic White patients (P <.01).

This analysis evaluated data from 295 Hispanic AYAs patients with ALL aged 17 to 39 enrolled in the phase 2 CALGB 10403 trial, which evaluated an intensive pediatric regimen in an AYA population. Data from the Surveillance, Epidemiology, and End Results registries were analyzed for US estimates of ALL outcomes.

In the CALGB 10403 cohort, patients who were of Hispanic descent demonstrated lower household income, had a higher frequency of CRLF2 aberrations, and higher rates of protocol completion compared with non-Hispanic Whites.

“Under-enrollment was in part due to a mis-alignment between the geographical distribution of enrollees and the distribution of Hispanic AYA ALL patients across the United States,” the authors wrote. The highest enrollment rate of Hispanic AYAs was in the Midwest at 15%. However, the overall enrollment of Hispanic AYAs was 19%, which was significantly lower than the 46% of Hispanic AYAs in the SEER cohort (P <.001).

The 3-year OS was similar between Hispanic and non-Hispanics White patients, with rates of 75% and 74%, respectively (P <.001). In the SEER cohort, 3-yar OS was 61% among Hispanic patients compared with 71% among non-Hispanic White patients.

The authors concluded that “we found that the outcomes of Hispanic trial enrollees were similar to non-Hispanic White trial enrollees and encouraging relative to US population-based estimates of survival among Hispanic AYAs with ALL.” They added that “these results are promising, especially as the Hispanic patients on CALGB 10403 were more likely than non-Hispanic White patients to exhibit high-risk Ph-like genetic profiles.”

Disclosures: Some of the study authors declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of disclosures.

Reference

Muffly L, Yin J, Jacobson S, et al. Disparities in trial enrollment and outcomes of Hispanic adolescent and young adult acute lymphoblastic leukemia. Blood Adv. 2022;6:4085-4092. doi: 10.1182/bloodadvances.2022007197

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