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Blood, 1 July 2006, Vol. 108, No. 1, pp. 74-80.
Prepublished online as a Blood First Edition Paper on March 14, 2006; DOI 10.1182/blood-2005-10-4004.
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CLINICAL TRIALS AND OBSERVATIONS
Ethnicity and survival in childhood acute myeloid leukemia: a report from the Children's Oncology Group
Richard Aplenc,
Todd A. Alonzo,
Robert B. Gerbing,
Franklin O. Smith,
Soheil Meshinchi,
Julie A. Ross,
John Perentesis,
William G. Woods,
Beverly J. Lange, and
Stella M. Davies
From the University of Pennsylvania, Philadelphia, PA; University of Southern California, Los Angeles, CA; Children's Oncology Group, Arcadia, CA; University of Cincinnati, Cincinnati, OH; University of Minnesota Cancer Center, Minneapolis, MN; Fred Hutchinson Cancer Research Center and University of Washington, Department of Pediatrics, Seattle, WA; and Emory University, Atlanta, GA.
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. (Blood. 2006;108:74-80)
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