Ethnicity and prognosis in acute myeloid leukemia

Abstract

Ethnicity has been described as a prognostic factor in breast cancer and in childhood acute lymphocytic leukemia but not in adult acute myeloid leukemia (AML). We reviewed the records of 225 consecutive AML patients who were diagnosed and treated between 1983 and 1995. Data were collected concerning demographic factors, presenting clinical features, and treatment protocols. We categorized ethnicity as follows: European Jews, non-European Jews, and Arabs. We assessed the role of ethnicity controlling for other known prognostic factors on treatment outcome and survival in this population. Older age, high leukocyte count at diagnosis, and high-risk chromosomal aberrations were significantly associated with overall survival in univariate analysis. In multivariate analysis high leukocyte count and high-risk chromosomal aberrations exerted an independent negative effect on survival. European origin was associated with longer event-free survival in univariate analysis (P = 0.024) and longer overall (P < 0.01) and event-free (P < 0.01) survival but not with a higher remission rate in multivariate analysis. For AML patients who achieved remission after induction chemotherapy and survived its complications, European origin is an independent favorable prognostic factor for long-term remission and survival in Israel. These findings may reflect better socioeconomic status, social support, increased compliance with treatment protocols, or better psychological coping mechanisms with malignancy. Am. J. Hematol. 72:127-134, 2003.

A population‐based study of hairy cell leukemia in Israel

“…This despite universal access to health services under the National Health Insurance Law in Israel. Similar findings have been observed in a hospital‐based series on acute myeloid leukemia (15). Even in the USA among insured cancer patients, survival has been found to vary by ethnic group (16).…”

Outcome of acute myeloid leukemia patients with hyperleukocytosis in Brazil

“…It can be assumed that the population in higher socioeconomic ranks live in urban areas and, consequently, have easier access to a better health care. We cannot rule out the possibility of the influence of ethnicity on prognosis in AML, as it has been suggested by others [23].…”

Clinical characteristics, response to therapy, and survival of African American patients diagnosed with chronic lymphocytic leukemia

“…There is extensive literature indicating that the prognosis for AA cancer patients, particularly for long‐term survival, is worse than that for whites across various hematologic malignancies, such as acute myeloid leukemia, acute lymphoblastic leukemia, Hodgkin and non‐Hodgkin lymphoma, and CLL . However, data in those reports are insufficiently detailed, and only “educated hypotheses” have been made to address this phenomenon.…”

“…Although approximately 66% of patients who progressed after initial treatment received subsequent therapy at our institutions, survival still may be influenced by treatment choices after disease progression and by the management of late complications or the timeliness of detecting relapses. There is extensive literature indicating that the prognosis for AA cancer patients, particularly for long-term survival, is worse than that for whites across various hematologic malignancies, such as acute myeloid leukemia, 8,[20][21][22] acute lymphoblastic leukemia, 6,8,23,24 Hodgkin 4,25 and non-Hodgkin lymphoma, 3,5,7,26 and CLL. 9,14 However, data in those reports are insufficiently detailed, and only ''educated hypotheses'' have been made to address this phenomenon.…”