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
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
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
Alex F. Herrera, MD, of the City of Hope National Medical Center, discusses results from the POLARIX study, which showed that circulating tumor DNA (ctDNA) analysis has prognostic value for patients with previously untreated diffuse large B-cell lymphoma. Patients who did not achieve 2.5 or greater log-fold change and/or did not have ctDNA clearance following one cycle of polatuzumab vedotin along with rituximab, cyclophosphamide, doxorubicin, and prednisone had inferior outcomes than those who did. Early changes in ctDNA levels may be of use in risk-adapted trial designs to identify patients in need of alternative treatment. (Abstract 542).
The ASCO Post Staff
Kathryn R. Tringale, MD, of Memorial Sloan Kettering Cancer Center, discusses an assessment of 559 patients with primary central nervous system (CNS) lymphoma and the factors associated with consolidation therapy selection, outcomes after consolidation therapy accounting for patient factors, and patterns of disease failure. The initial treatment response was prognostic and predictive of relapse patterns (Abstract 557).
The ASCO Post Staff
Eileen M. Boyle, MD, PhD, of the Perlmutter Cancer Center, NYU Langone Health, discusses Fc-mediated antibody effector function, inflammation resolution, and oligoclonality and their role in predicting sustained measurable residual disease negativity in patients with newly diagnosed multiple myeloma who were treated with immunotherapy regimens. For the first time, an analysis of T-cell receptors shows that oligoclonal profiles seen on treatment may influence the fitness of the immune response (Abstract 100).
