An investigation of toxicities and survival in Hispanic children and adolescents with ALL: Results from the Dana‐Farber Cancer Institute ALL Consortium protocol 05‐001

Kahn, Justine M.; Cole, Peter D.; Blonquist, Traci M.; Stevenson, Kristen E.; Jin, Zhezhen; Barrera, Sergio; Davila, Randy; Roberts, Elizabeth S.; Neuberg, Donna; Athale, Uma H.; Clavell, Luis A.; Laverdière, Caroline; Leclerc, Jean Marie; Michon, Bruno; Schorin, Marshall A.; Welch, Jennifer; Sallan, Stephen E.; Silverman, Lewis B.; Kelly, Kara M.

doi:10.1002/pbc.26871

Cited by 25 publications

(24 citation statements)

References 51 publications

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“… 19 , 20 , 21 The lower incidence of T-ALL in our study seems to confirm the geographic variation in the biologic subtype expression due to genetic heterogeneity and diversity according to the ethnic composition. 22 , 23 …”

Section: Discussionsupporting

confidence: 86%

Childhood T-cell acute lymphoblastic leukemia in a single Latin American center: impact of improved treatment scheme and support therapy on survival

Jaime‐Pérez

Santos

Gómez‐Almaguer

2020

Hematology, Transfusion and Cell Therapy

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Background and objective T-cell acute lymphoblastic leukemia (T-ALL) in children represents a high-risk disease. There is a lack of studies assessing the outcome of T-ALL in Hispanic populations, in which it is a rare malignancy. We report the characteristics and results of treatment for childhood T-cell ALL in children over 14 years at a Latin American reference center. Material and methods From January 2005 to December 2018, there occurred the analysis of twenty patients ≤ 16 years of age from a low-income open population diagnosed at a university hospital in Northeast Mexico. Clinical and laboratory characteristics, treatment regimens and outcomes were assessed by scrutinizing clinical records and electronic databases. Diagnosis was confirmed by flow cytometry, including positivity for CD-2, 5, 7 and surface/cytoplasmic CD3. Survival rates were assessed by the Kaplan-Meier method. Results There was a male preponderance (70 %), with a 2.3 male-to-female ratio ( p =  .074), the median age being 9.5 years. Leucocytes at diagnosis were ≥ 50 × 10 9 /L in 13 (65 %) children, with CNS infiltration in 6 (30 %) and organomegaly in 10 (50 %). The five-year overall survival (OS) was 44.3 % (95 % CI 41.96–46.62), significantly lower in girls, at 20.8 % (95 % CI 17.32–24.51) vs. 53.1 % (95 % CI 50.30–55.82), ( p = .035) in boys; there was no sex difference in the event-free survival (EFS) ( p = .215). The survival was significantly higher after 2010 ( p = .034). Conclusion The T-cell ALL was more frequent in boys, had a higher mortality in girls and the survival has increased over the last decade with improved chemotherapy and supportive care.

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Section: Discussionsupporting

confidence: 86%

Childhood T-cell acute lymphoblastic leukemia in a single Latin American center: impact of improved treatment scheme and support therapy on survival

Jaime‐Pérez

Santos

Gómez‐Almaguer

2020

Hematology, Transfusion and Cell Therapy

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“…325 Similarly, the incidence of adult ALL is the highest in Hispanics/Latinos. 326 Moreover, outcomes are generally poorer for both childhood and adult ALL in Hispanics/Latinos compared with NHWs 309,[327][328][329][330][331] probably due to disparities in SES, 328,332 an increased frequency of the high-risk Philadelphia chromosome (Ph)-like subtype [333][334][335] and the increased Indigenous American genetic ancestry in Hispanic/ Latino patients (see below). 17 Potential aetiological factors Germline loss-of-function variants in NUDT15, which confer a major cause of treatment-related toxicity due to thiopurine intolerance, are more common in Hispanic/Latino ALL patients than in NHW patients-in particular, in Hispanics/Latinos with high Indigenous American ancestry.…”

Section: Disparities In Leukaemiamentioning

confidence: 99%

Cancer health disparities in racial/ethnic minorities in the United States

et al. 2020

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There are well-established disparities in cancer incidence and outcomes by race/ethnicity that result from the interplay between structural, socioeconomic, socio-environmental, behavioural and biological factors. However, large research studies designed to investigate factors contributing to cancer aetiology and progression have mainly focused on populations of European origin. The limitations in clinicopathological and genetic data, as well as the reduced availability of biospecimens from diverse populations, contribute to the knowledge gap and have the potential to widen cancer health disparities. In this review, we summarise reported disparities and associated factors in the United States of America (USA) for the most common cancers (breast, prostate, lung and colon), and for a subset of other cancers that highlight the complexity of disparities (gastric, liver, pancreas and leukaemia). We focus on populations commonly identified and referred to as racial/ethnic minorities in the USA—African Americans/Blacks, American Indians and Alaska Natives, Asians, Native Hawaiians/other Pacific Islanders and Hispanics/Latinos. We conclude that even though substantial progress has been made in understanding the factors underlying cancer health disparities, marked inequities persist. Additional efforts are needed to include participants from diverse populations in the research of cancer aetiology, biology and treatment. Furthermore, to eliminate cancer health disparities, it will be necessary to facilitate access to, and utilisation of, health services to all individuals, and to address structural inequities, including racism, that disproportionally affect racial/ethnic minorities in the USA.

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“…Reasons for the higher rates in Hispanic children are not understood, but may result from variation in collective genetic and environmental exposures . Hispanic children also have inferior leukemia survival, which appears to stem from a higher likelihood of relapse, perhaps because of differences in drug efficacy that might be overcome with a more individualized chemotherapy regimen . The 5‐year survival rate for ALL is 90% in Hispanic children and 95% in NHW children, whereas survival for AML is 68% and 74%, respectively .…”

Section: Selected Findingsmentioning

confidence: 99%

“…43,82 Hispanic children also have inferior leukemia survival, which appears to stem from a higher likelihood of relapse, perhaps because of differences in drug efficacy that might be overcome with a more individualized chemotherapy regimen. 83,84 The 5-year survival rate for ALL is 90% in Hispanic children and 95% in NHW children, whereas survival for AML is 68% and 74%, respectively. 8 Incidence trends from 1992 through 2015 are generally similar for Hispanics and NHWs based on SEER data; from 2006 to 2015, rates for ALL increased slightly, by approximately 1% per year, but were stable for AML.…”

Section: Childhood Leukemiamentioning

confidence: 99%

Cancer Statistics for Hispanics/Latinos, 2018

Miller

Sauer

Ortiz³

et al. 2018

CA A Cancer J Clinicians

382

296

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Cancer is the leading cause of death among Hispanics/Latinos, who represent the largest racial/ethnic minority group in the United States, accounting for 17.8% (57.5 million) of the total population in the continental United States and Hawaii in 2016. In addition, more than 3 million Hispanic Americans live in the US territory of Puerto Rico. Every 3 years, the American Cancer Society reports on cancer occurrence, risk factors, and screening for Hispanics in the United States based on data from the National Cancer Institute, the North American Association of Central Cancer Registries, and the Centers for Disease Control and Prevention. For the first time, contemporary incidence and mortality rates for Puerto Rico, which has a 99% Hispanic population, are also presented. An estimated 149,100 new cancer cases and 42,700 cancer deaths will occur among Hispanics in the continental United States and Hawaii in 2018. For all cancers combined, Hispanics have 25% lower incidence and 30% lower mortality compared with non‐Hispanic whites, although rates of infection‐related cancers, such as liver, are up to twice as high in Hispanics. However, these aggregated data mask substantial heterogeneity within the Hispanic population because of variable cancer risk, as exemplified by the substantial differences in the cancer burden between island Puerto Ricans and other US Hispanics. For example, during 2011 to 2015, prostate cancer incidence rates in Puerto Rico (146.6 per 100,000) were 60% higher than those in other US Hispanics combined (91.6 per 100,000) and 44% higher than those in non‐Hispanic whites (101.7 per 100,000). Prostate cancer is also the leading cause of cancer death among men in Puerto Rico, accounting for nearly 1 in 6 cancer deaths during 2011‐2015, whereas lung cancer is the leading cause of cancer death among other US Hispanic men combined. Variations in cancer risk are driven by differences in exposure to cancer‐causing infectious agents and behavioral risk factors as well as the prevalence of screening. Strategies for reducing cancer risk in Hispanic populations include targeted, culturally appropriate interventions for increasing the uptake of preventive services and reducing cancer risk factor prevalence, as well as additional funding for Puerto Rico‐specific and subgroup‐specific cancer research and surveillance.

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An investigation of toxicities and survival in Hispanic children and adolescents with ALL: Results from the Dana‐Farber Cancer Institute ALL Consortium protocol 05‐001

Cited by 25 publications

References 51 publications

Childhood T-cell acute lymphoblastic leukemia in a single Latin American center: impact of improved treatment scheme and support therapy on survival

Childhood T-cell acute lymphoblastic leukemia in a single Latin American center: impact of improved treatment scheme and support therapy on survival

Cancer health disparities in racial/ethnic minorities in the United States

Cancer Statistics for Hispanics/Latinos, 2018

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