Survival Disparities in Pediatric Acute Lymphocytic Leukemia and Acute Myeloid Leukemia: An Analysis of Population-Based Florida Cancer Registry (1981-2009)
Methods: Florida Cancer Data System(1981-2009) was linked with US census to explore median survival and 1-, 3-, 5-year survival rates by demographics. Survival was compared by gender, race/ethnicity, NPS and modeled with multivariate Cox regression to calculate hazard ratio(HR) and 95% confidence interval(95%CI).
Results: Of the 3,679 pediatric leukemia cases, 79.2% were ALL, 17.4%AML, 3.4%CML.
Overall ALL median survival was 3.4yrs(95%CI:3.1-3.8) where Whites(3.8;3.4-4.2) had longer survival than Blacks(2.2;1.8-2.5) and Other races(3.0). Hispanics(4.6;3.4-6.0) had longer survival than non-Hispanics(3.2). Middle-high NPS(3.9;3.2-5.4) had longest median survival; lowest NPS had shortest(2.8). Males(3.4) and females(3.5) had similar survival.
AML median survival was 1.2 yrs(1.0-1.3) with Whites(1.2;1.1-1.4) having longer survival than Blacks(1.0;0.8-1.7) and Other race(1.1). Hispanics(1.3;1.1-1.8) had similar survival to non-Hispanics(1.1). For pediatric AML, median survival was similar for all NPS and between males(1.2) and females(1.1).
Blacks had worse ALL survival compared to Whites(HR=[1.7];95%CI:1.4-2.1), and Hispanics had better survival than non-Hispanics([0.7];0.6-0.8). Middle-high NPS had better survival than lowest NPS([0.8];0.6-1.0). Similar significant survival disparities were not found for AML.
Conclusions: Elucidating ALL and AML survival showed race/ethnicity, NPS, and gender differences within and between the most common pediatric leukemias. Survival disparities were seen in ALL but not AML. Understanding ALL and AML survival differences may provide a base for culturally competent pediatric cancer prevention programs.
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Describe ALL and AML survival differences between race/ethnicity, SES, and gender within and between the most common pediatric leukemia types.
Keyword(s): Cancer, Children and Adolescents
Qualified on the content I am responsible for because: I am a second-year medical student who researches cancer epidemiology and disparities.
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