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.
The ASCO Post Staff
Eunice S. Wang, MD, of Roswell Park Comprehensive Cancer Center, discusses the outcomes of patients newly diagnosed with acute myeloid leukemia (AML) who were treated with cytarabine plus daunorubicin plus gemtuzumab ozogamicin (GO). These patients experienced higher rates of measurable residual disease–negative complete remission and complete remission with incomplete count recovery, compared to those treated with cytarabine plus idarubicin daunorubicin alone. Although adding GO was not associated with improved overall survival, longer follow-up is warranted to determine an absolute survival advantage of this regimen (Abstract 58).
The ASCO Post Staff
Jorge E. Cortes, MD, of Georgia Cancer Center at Augusta University, discusses new findings on vodobatinib, which was administered to patients with chronic-phase Philadelphia chromosome–positive chronic myeloid leukemia (CML) and appeared to be efficacious and safe in people who had received therapy with two or three prior tyrosine kinase inhibitors (TKIs). Vodobatinib remains a potential option for these highly refractory patients. A phase II study (NCT02629692) of vodobatinib is ongoing in CML patients whose disease has failed to respond to three or more TKIs, including ponatinib (Abstract 84).
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
Mark R. Litzow, MD, of the Mayo Clinic, discusses phase III results from the ECOG-ACRIN E1910 Trial, which show that adding blinatumomab to consolidation chemotherapy resulted in a significantly better overall survival in adult patients aged 30 to 70 years with newly diagnosed B-lineage acute lymphocytic leukemia (ALL) who were measurable residual disease–negative after receiving intensification chemotherapy. The authors believe this may represent a new standard of care for this population (Abstract LBA-1).
The ASCO Post Staff
Irene Roberts, MD, of Oxford’s Weatherall Institute of Molecular Medicine, discusses children with Down syndrome, who have a more than 100-fold increased risk of developing acute myeloid leukemia before their fourth birthday compared to children without Down syndrome. Their risk of acute lymphoblastic leukemia is also increased by around 30-fold. Dr. Roberts details current knowledge about the biologic and molecular basis of this relationship between leukemia and Down syndrome, the role of trisomy 21 in leukemogenesis, and the clinical implications of these findings.
