Hispanic ethnicity is associated with younger age at presentation but worse survival in acute myeloid leukemia

Darbinyan, Karine; Shastri, Aditi; Budhathoki, Anjali; Helbig, Daniel; Snyder, Rose; Pradhan, Kith; Saleh-Esa, Junaid; Kornblum, Noah; Binder, Adam; Goel, Swati; Janakiram, Murali; Derman, Olga; Gritsman, Kira; Steidl, Ulrich; Braunschweig, Ira; Verma, Amit; Mantzaris, Ioannis

doi:10.1182/bloodadvances.2017007013

Cited by 15 publications

(16 citation statements)

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“…Ethnic and racial disparities have been described in the outcomes of hematological malignancies such as acute leukemia and attributed to a combination of biological and non-biological factors [ 13 , 14 ]. Age-adjusted overall survival of AML was reported to be worse in Hispanics compared with whites [ 11 ]. It was demonstrated that cytogenetic abnormalities are common in AML and are associated with a significant prognostic impact on AML patients.…”

Section: Discussionmentioning

confidence: 99%

“…AML appears less common in Hispanics when compared with whites; however, acute promyelocytic leukemia (APL) appears comparatively more common in Hispanics when compared with whites [ 16 ]. It was revealed that there were significantly higher mutation rates of ASXL1 and TET2 genes in Hispanic AML patients than in white AML patients, which may provide a biological explanation for the inferior outcomes of AML in Hispanics [ 11 ]. The varied distribution of acute leukemia among these ethnic groups suggests that host susceptibility factors are critical determinants of disease in one group, but not in another group [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…It was revealed that there were significantly higher mutation rates of ASXL1 and TET2 genes in Hispanic AML patients than in white AML patients, which may provide a biological explanation for the inferior outcomes of AML in Hispanics [ 11 ]. The varied distribution of acute leukemia among these ethnic groups suggests that host susceptibility factors are critical determinants of disease in one group, but not in another group [ 11 ]. The extent to which the environment interacts with these factors is unknown.…”

Section: Discussionmentioning

confidence: 99%

“…African Americans continue to have higher cancer mortality rates and shorter overall survival [ 10 ]. Age-adjusted overall survival of acute myeloid leukemia (AML) was reported to be worse in Hispanics compared with whites [ 11 ]. It was reported that Hispanic whites had an age-adjusted lower incidence rate of CMML compared to non-Hispanic whites [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Cytogenetic and molecular landscape and its potential clinical significance in Hispanic CMML patients from Puerto Rico

Jiang

Sun

et al. 2020

Oncotarget

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Chronic myelomonocytic leukemia (CMML) is a clonal hematopoietic neoplasm that exhibits myelodysplastic and myeloproliferative characteristics with heterogeneous clinical and pathological features. There are limited publications on the ethnic and racial disparity of cytogenetics and genomics in CMML patients. This study aims to define the cytogenetic and molecular landscape in Hispanic CMML patients from Puerto Rico and explore its possible clinical significance. One hundred and eleven (111) Hispanic CMML patients from Puerto Rico were diagnosed in our institute from 2009 to 2018. Karyotypes were available in one hundred and seven (107) patients. Seventeen (17) patients had abnormal karyotypes (17/107, 16%). Compared to previously published data, Hispanic CMML patients in this study had significantly lower rates of overall cytogenetic abnormalities (16% vs 27-28%, p < 0.05) and trisomy 8 (2% vs 7%, p < 0.05). Among one hundred and eleven (111) Hispanic CMML patients, 40gene myeloid molecular profile tests were performed in fifty-six (56) CMML patients. Gene mutations were identified in fifty-four (54) patients (96%). The most frequent mutated genes were: TET2, SRSF2, ASXL1, ZRSR2, DNMT3A, NRAS, CBL, and RUNX1. Twenty-nine (29) out of fifty-six (56) patients (29/56, 52%) had mutated TET2/wild type ASXL1 (muTET2/wtASXL1). Previous studies indicated that mutated ASXL1, DNMT3A, NRAS, RUNX1, and SETBP1 may associate with an unfavorable prognosis and muTET2/wtASXL1 may associate with a favorable prognosis in CMML patients. Compared to previously published data, Hispanic CMML patients from Puerto Rico in this study had significantly lower mutation rates in ASXL1 and SETBP1, and a higher rate of muTET2/wtASXL1. The findings raise the possibility of a favorable prognosis in Hispanic CMML patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cytogenetic and molecular landscape and its potential clinical significance in Hispanic CMML patients from Puerto Rico

Jiang

Sun

et al. 2020

Oncotarget

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“…However, the presence of these favorable markers does not translate into improved clinical outcomes (Darbinyan et al, 2017;Kirtane and Lee, 2017;Patel et al, 2013;Patel et al, 2012;Patel et al, 2015). Additional biological factors contributing to this health disparity include mutations in CEBPA, RUNX1, GATA2, AML1-ETO, U2AF1, and KIT, which was observed at a higher prevalence in Hispanic versus NHWs.…”

Section: Acute Myeloid Leukemia (Aml)mentioning

confidence: 99%

Blood cancer health disparities in the United States Hispanic population

Bencomo‐Alvarez

Rubio

Gonzalez

et al. 2021

Cold Spring Harb Mol Case Stud

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Cancer is a challenging, multifaceted disease that involves a combination of biological and non-biological factors. Aside from COVID-19, cancer is the second leading cause of death in the United States (U.S.), and the first among Hispanic Americans. The Hispanic population is the largest minority group in the U.S., which is rapidly growing in size. Unfortunately, U.S. Hispanics and other minority groups experience many different health disparities, resulting in poor survival outcomes and a reduced quality of life. Factors such as genomic mutations, lower socioeconomic status, lack of education, reduced access to health care, comorbidities, and environmental factors all contribute to these health care inequalities. In the context of blood cancer health disparities, Hispanic patients are often diagnosed at a younger age and have worse outcomes compared with non-Hispanic individuals. In the present article, we highlight the existing knowledge about cancer health disparities in the Hispanic population, with a focus on chronic and acute leukemia. In our experience at the U.S./Mexico border, analysis of several different blood cancers demonstrated that younger Hispanic patients with acute lymphoid or myeloid leukemia have higher incidence rates and worse prognoses. A combined approach, involving improved health care access and better knowledge of the underlying factors, will allow for more timely diagnoses and the development of intervention strategies aimed at reducing or eliminating the disparities.

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Disparities in mortality among acute myeloid leukemia‐related hospitalizations

et al. 2022

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Racial and socioeconomic disparities have become apparent in acute myeloid leukemia (AML) outcomes. We conducted a retrospective cohort study of hospitalizations for adults with a diagnosis of AML from 2009 to 2018 in the Nationwide Inpatient Sample (NIS). We categorized patients' ages in groups of <60 years and ≥60 years and stratified them by reported race/ethnicity. Exposures of interest were patient sociodemographics, hospital characteristics, and Elixhauser‐comorbidity Index. Outcome of interest was in‐hospital death. Statistical analyses included survey logistic regression to generate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to quantify the independent associations between patient characteristics and mortality. Of 622,417 AML‐related hospitalizations, 57.6% were in patients ≥60 years. The overall rate of in‐hospital death was 9.4%. Compared to patients <60, older patients experienced a higher rate of in‐hospital death. In both age groups and in all ethnicities, mortality decreased over time. Differences in mortality were observed based on gender, payer, hospital location, and teaching status. For hospitalizations in patients ≥60, NH‐Black race was associated with inferior in‐hospital death outcomes (OR 1.17; CI 1.08–1.28). Urban teaching hospitals were associated with a 38% increase (OR 1.38; CI 1.06–1.80) in inpatient mortality in patients <60 and a 15% decrease (OR 0.85; CI 0.77–0.95) in inpatient mortality in patients ≥60. Our results highlight the increased need to recognize the role of race/ethnicity and socioeconomic factors and their contribution to disparate outcomes in AML.

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Hispanic ethnicity is associated with younger age at presentation but worse survival in acute myeloid leukemia

Abstract: Key Points SEER data and a Bronx validation cohort demonstrate that Hispanics present with AML at younger age but have shorter survival than whites. Increased frequency of high-risk mutations in Hispanics provides a potential biologic explanation for poorer outcomes in Hispanics.

Cited by 15 publications

References 15 publications

Cytogenetic and molecular landscape and its potential clinical significance in Hispanic CMML patients from Puerto Rico

Cytogenetic and molecular landscape and its potential clinical significance in Hispanic CMML patients from Puerto Rico

Blood cancer health disparities in the United States Hispanic population

Disparities in mortality among acute myeloid leukemia‐related hospitalizations

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