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
Eva Hoster, PhD, of Munich University, discusses results from the European MCL Elderly Trial, which confirmed the strong efficacy of rituximab maintenance in minimal residual disease (MRD)-negative patients with mantle cell lymphoma (MCL) after induction. Omitting maintenance based on MRD-negativity is thus discouraged. Considering the short time to progression, more effective treatment strategies should be explored in MRD-positive patients to improve long-term prognosis (Abstract 544).
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
Julie Côté, MD, of CHU de Québec–Université Laval, discusses findings from the Canadian Myeloma Research Group database, which showed that integrating bortezomib and lenalidomide into the autologous stem cell transplant (ASCT) sequence produces a median overall survival rate ≥ 10 years in most patients with newly diagnosed multiple myeloma. These observations highlight the contribution of post-ASCT maintenance, particularly lenalidomide given until disease progression, when used in multiple patient groups including those with and without high risk, as well as those requiring a second induction regimen (Abstract 117).
The ASCO Post Staff
Jiye Liu, PhD, of Dana-Farber Cancer Institute, discusses study findings that demonstrate KDM6A regulates CD38 and CD48 expression in multiple myeloma. Dr. Liu’s team validated combination treatment with an FDA-approved EZH2 inhibitor plus daratumumab, which can overcome daratumumab resistance in preclinical multiple myeloma models, providing the rationale for combination clinical trials to improve patient outcome (Abstract 148).
