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Blood, 1 June 2004, Vol. 103, No. 11, pp. 4036-4042.
Prepublished online as a Blood First Edition Paper on February 19, 2004; DOI 10.1182/blood-2003-09-3118.
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CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Differences in prognostic factors and outcomes in African Americans and whites with acute myeloid leukemia
Mikkael A. Sekeres,
Bercedis Peterson,
Richard K. Dodge,
Robert J. Mayer,
Joseph O. Moore,
Edward J. Lee,
Jonathan Kolitz,
Maria R. Baer,
Charles A. Schiffer,
Andrew J. Carroll,
James W. Vardiman,
Frederick R. Davey,
Clara D. Bloomfield,
Richard A. Larson, and
Richard M. Stone, for the Cancer and Leukemia Group B (CALGB)
From the Department of Hematology and Medical Oncology, The Cleveland Clinic Foundation, Cleveland, OH; The Cancer and Leukemia Group B Statistical Center, Durham, NC; Department of Adult Oncology, The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Duke University Medical Center, Durham, NC; Sinai Hospital of Baltimore, Baltimore, MD; North Shore University Hospital, New York University School of Medicine, Manhasset, NY; Roswell Park Cancer Institute, Buffalo, NY; Karmanos Cancer Institute, Wayne State University, Detroit, MI; University of Alabama at Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; SUNY Upstate Medical University, Syracuse, NY; and The Ohio State University, Columbus, OH.
Whites have a more favorable prognosis than African Americans for a number of cancers. The relationship between race and outcome is less clear in acute myeloid leukemia (AML). Using data from 7 Cancer and Leukemia Group B studies initiated from 1985 to 1997, we conducted a retrospective cross-sectional analysis of 2570 patients (270 African American and 2300 white) with de novo AML who received induction chemotherapy. African Americans were younger than whites (48 versus 54 years, P < .001). African Americans also had different cytogenetic risk group distributions than whites (P < .001): they were more commonly classified in the favorable (23% versus 14%) and unfavorable (31% versus 23%) groups, and less commonly classified in the intermediate group (47% versus 63%). African American men had a lower complete remission (CR) rate (54%, compared with 64% for white men, 65% for white women, and 70% for African American women, P = .001) and a worse overall survival compared with all other patients (P = .004), when known risk factors are taken into account. African Americans and whites with AML differ with respect to important prognostic factors. African American men have worse CR rates and overall survival than whites and African American women, and should be considered a poor-risk group.
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