When scientists at the OSUCCC – James explored factors that might contribute to this disparity, they found that, even when Black patients received the same treatment and follow-up care as their white counterparts, they still fared worse. This remained true in Black patients whose cancer carried genetic mutations that typically predict better prognosis and survival.
The researchers found that survival among young Black people with AML is “strikingly and unacceptably worse” than that seen in white patients with AML, particularly in younger patients. When the researchers looked at the mutations seen in AML, even Black patients with good prognostic risk factors experienced poorer outcomes.
The researchers presented their findings at the 2020 virtual annual meeting of the American Society of Hematology and published them in the journal Cancer Discovery.
For this study, they used the National Cancer Institute’s Cancer Surveillance, Epidemiology and End Results (SEER) database to identify over 25,000 adults diagnosed with AML between 1986 and 2015. They found that, while survival for AML patients as a whole has improved, survival disparities between Black and white patients with AML have widened despite improved treatment and understanding of AML. They also identified a disparity in survival rates between young Black and white patients under age 60, who respectively had three-year overall survival rates of 34% and 43%.
Historically, the researchers stated, one of the biggest arguments for the poorer survival seen among Black AML patients has been challenges with access to treatment. However, the scientists found that even if patients have the same access and the same rates of remission, Black patients have significantly shorter survival time compared to white patients.
Study collaborator Ann-Kathrin Eisfeld, MD, and her team conducted genomic analyses to look at 81 genes commonly mutated in AML. Knowing whether a patient has these mutations helps clinicians customize treatment plans.
“We know that, when looking at the AML patient population, certain mutations are associated with better outcomes,” Eisfeld says. “In this study, we showed this didn’t hold true for all of them when we looked at Black patients alone. And when we analyzed factors that influence survival in all younger AML patients, Black race was an independent predictor of poor outcome. This suggests that Black race itself seems to be such a strong risk factor that it adds to the markers we rely on to risk-stratify patients.”