Disparities in receiving disease-directed therapy, allogeneic stem cell transplantation in non-Hispanic Black patients with TP53-mutated acute myeloid leukemia Journal Article

  

Authors:	Badar, T.; Litzow, M. R.; Shallis, R. M.; Patel, A.; Saliba, A. N.; Burkart, M.; Bewersdorf, J. P.; Stahl, M.; De Camargo Correia, G. S.; Guru Murthy, G. S.; Abaza, Y.; Duvall, A.; Bradshaw, D.; Kota, V.; Dinner, S.; Goldberg, A. D.; Palmisiano, N.; Al Kali, A.; Atallah, E.
Article Title:	Disparities in receiving disease-directed therapy, allogeneic stem cell transplantation in non-Hispanic Black patients with TP53-mutated acute myeloid leukemia
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. © 2022 American Cancer Society.
Keywords:	retrospective studies; genetics; leukemia, myeloid, acute; clinical trial; hematopoietic stem cell transplantation; retrospective study; protein p53; multicenter study; tumor suppressor protein p53; tp53 protein, human; caucasian; acute myeloid leukemia (aml); acute myeloid leukemia; humans; human; allogeneic hematopoietic stem cell transplantation (allo-hsct); structural racism; disparities in leukemia; tp53mutation; black or african american; white people
Journal Title:	Cancer
Volume:	129
Issue:	6
ISSN:	0008-543X
Publisher:	Wiley Blackwell
Date Published:	2023-03-15
Start Page:	934
End Page:	945
Language:	English
DOI:	10.1002/cncr.34604
PUBMED:	36545710
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85144909890&doi=10.1002%2fcncr.34604&partnerID=40&md5=90086975b81f089644789447507a5ae1
Notes:	Article -- Export Date: 1 March 2023 -- Source: Scopus

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