Abdul Rahman Al Armashi, MD, on AML: Racial Disparities in Mortality Trends
2022 ASH Annual Meeting and Exposition
Abdul Rahman Al Armashi, MD, of Seidman Cancer Center, Case Western University, University Hospitals Cleveland Medical Center, discusses a retrospective analysis, using a CDC database, in one of the largest subgroup-based racial population studies analyzing mortality trends in patients with acute myeloid leukemia (AML). Between 2000 and 2019, AML mortality was the highest in Whites and the lowest in American Indians or Alaska Natives. The highest rate of increase in mortality was seen in Asians or Pacific Islanders. Dr. Al Armashi talks about the many variables that might contribute to these inequalities (Abstract 600).
Transcript
Disclaimer: This video transcript has not been proofread or edited and may contain errors.
AML is one of the most prevalent forms of acute leukemia. Despite treatment advances, the High V relative survivor rate still has an eerie percent. In the recent data published by the National Cancer Institute, the death threat didn't show any improvement from 1992 to 2020. We conducted a retrospective analysis evaluating the race-specific mortality trends in an old patient with AML in the United States, giving the vacuity of studies evaluating those disparities. We used the CDC Wonder database which contained national mortality and population data. Also, it includes the cause of death from all death certificates filed in the United States. Our population included all patients who died from AML. We also included all races and ethnic groups in the United States from 2000 to 2019. Age-adjusted mortality was calculated per 1 million per person stratified by race and standardized to the US census of 2000. In our study, we found that the age-adjusted mortality was increased equally in both white and black groups.
Also, we found that the mortality trends increased dramatically in the Asian Pacific Islander Group by 25%. It decreased in the Native Americans by 29%. Also, we found that the mortality trends increased by 5% in Hispanics and 3% in non-Hispanic. To our knowledge, this is the largest real-world data study evaluating race and ethnicity specific mortality trends of AML. Multiple variables might contribute to those disparities, including genetics, risk factors, socioeconomic status, equal access to healthcare, and also a response to treatment. Further studies are needed to evaluate those factors and to develop a method to close this gap.
Related Videos
The ASCO Post Staff
Jia Ruan, MD, PhD, of Meyer Cancer Center, Weill Cornell Medicine, and NewYork-Presbyterian Hospital, discusses trial results demonstrating that the triple chemotherapy-free combination of acalabrutinib, lenalidomide, and rituximab is well tolerated, highly effective, and produces high rates of minimal residual disease (MRD)-negative complete response as an initial treatment for patients with mantle cell lymphoma, including those with TP53 mutations. Real-time MRD analysis may enable treatment de-escalation during maintenance to minimize toxicity, which warrants further evaluation. An expansion cohort of acalabrutinib/lenalidomide/obinutuzumab is being launched (Abstract 73).
The ASCO Post Staff
Smita Bhatia, MD, MPH, of the Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, discusses study findings that showed key somatic mutations in the peripheral blood stem cell product increases the risk of developing therapy-related myeloid neoplasms (Abstract 119).
The ASCO Post Staff
Andrew Matthews, MD, of the Abramson Cancer Center, University of Pennsylvania, discusses findings from a large, multicenter study that showed superior outcomes with 7 + 3 chemotherapy (cytarabine continuously for 7 days, along with short infusions of an anthracycline on each of the first 3 days) vs venetoclax in patients with acute myeloid leukemia (AML). In this real-world data set, the 7 + 3 cohort outperformed historical benchmarks in overall survival and early mortality, perhaps reflecting improved later lines of therapy and patient selection. Prospective studies (such as NCT04801797) must confirm the superiority of intensive chemotherapy (Abstract 426).
The ASCO Post Staff
Paolo F. Caimi, MD, of the Taussig Cancer Institute, Cleveland Clinic, discusses new findings showing that patients with diffuse large B-cell lymphoma (DLBCL) who achieve a complete response after salvage therapy with rituximab, ifosfamide, carboplatin, and etoposide (R-ICE) can achieve long-term disease control, regardless of the time to relapse from initial therapy, particularly if they proceed to autologous stem cell transplant (ASCT). These results suggest that second-line chemotherapy followed by ASCT and/or CAR T-cell therapy for chemosensitive and chemorefractory patients may maximize patient outcomes, regardless of time to relapse (Abstract 156).
The ASCO Post Staff
Jennifer R. Brown, MD, PhD, of Dana-Farber Cancer Institute, discusses phase III findings of the ALPINE study, which showed that zanubrutinib is more efficacious and better tolerated than ibrutinib as a treatment for patients with relapsed or refractory chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). In this first head-to-head comparison of the two BTK inhibitors, the superior progression-free survival of zanubrutinib was observed across all major subgroups, including high-risk patients (Abstract LBA-6).
