Racial Disparity Found in Survival Rates of Children with a Common Leukemia

Black, Hispanic and Native American children with Acute Lymphoblastic Leukemia (ALL), have worse survival than white and Asian children, even with the availability of modern therapies, Yale researchers report in the October 15 issue of Journal of the American Medical Association.

Led by Principal Investigator Nina Kadan-Lottick, M.D., associate research scientist in pediatrics at Yale School of Medicine, the researchers conducted a population-based study of 5,000 children younger than age 20 who were diagnosed with ALL, the most common childhood malignancy in the United States. They used the National Cancer Institute’s Standardized Epidemiology End Result (SEER) database to determine survival rates according to race and ethnicity. The database includes ethnicity and survival information from nine population centers around the country.

“We found that in the modern treatment era, black and Hispanic children still have worse outcome from leukemia than comparable white children,” said Kadan-Lottick. “Survival ratio was 1.5 times worse for black children and 1.8 times worse for Hispanic children. The largest difference by race or ethnicity was observed among children diagnosed between ages one and nine years.”

Kadan-Lottick said the reason for the disparity is unclear and further attention is needed to answer this question. The possibilities that must be explored include: differences in response to the same medications, differences in access to care, or differences in compliance with therapy.”

“Previous studies and the current one from St. Jude’s are based on the experience of a single referral center,” Kadan-Lottick added. “The advantage of our study is that it is based on a national population-based registry.”

Kadan-Lottick said that while data from the St. Jude’s study is very valuable because it contains much clinical data, it might not be representative of the average American childhood leukemia patient. “Their patients are provided free care and are self-selected,” she said.

Other authors on the study included Kirsten K. Ness and James G. Gurney of the University of Minnesota; and Smita Bhatia, M.D., of the City of Hope National Medical Center in Duarte, California.

Citation: Journal of the American Medical Association, October 5, 2003-Vol. 290, No. 15.

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Karen N. Peart: karen.peart@yale.edu, 203-432-1326