The following article features coverage from the 2021 American Society of Hematology Annual Meeting. Click here to read more of Cancer Therapy Advisor’s conference coverage.

Black adolescents and young adults (AYAs) with acute myeloid leukemia (AML) have shorter overall survival (OS) than White AYAs with AML, according to research presented at the 2021 American Society of Hematology (ASH) Annual Meeting.

The reasons for this disparity are “undoubtedly multifactorial,” but the disparity is driven by patients aged 18-29 years, said Karilyn Larkin, MD, of the Ohio State University Comprehensive Cancer Center in Columbus, who presented the research at the meeting.

The study included 85 Black and 481 White patients, ages 18-39 years, with de novo AML. All patients received standard cytarabine-anthracycline induction. A subset of 50 Black patients and 277 White patients underwent molecular assessment.


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At baseline, the Black and White patients had similar clinical characteristics, including white blood cell counts (P =.91), bone marrow blast percentage (P =.90), extramedullary involvement (P =.62), and number of consolidation cycles (P =.90).

Fewer Black patients had cytogenetically normal AML (19% vs 40%), but more Black patients had core-binding factor AML (37% vs 22%).

Black patients were more likely to have KRAS variants (16% vs 5%; P =.01), ASXL1 variants (12% vs 1%; P <.001), and ZRSR2 variants (6% vs 0%; P =.01). But Black patients were less likely to have NPM1 variants (4% vs 29%; P =.01) or CEBPA variants (17% vs 3%; P =.02).

Black patients had a significantly higher rate of death within 30 days of diagnosis (11% vs 2%; P <.001) and significantly shorter median OS (1.5 years vs 3.1 years; P =.002). Black patients were also less likely to achieve complete remission (CR), but the difference was not significant (73% vs 82%; P =.06).

There were no significant differences in CR, early death, or OS between Black and White patients aged 30-39 years.

However, among patients aged 18-29 years, Black patients had a significantly higher rate of early death (16% vs 3%; P =.002), shorter median OS (1.3 years vs 10.2 years; P <.001), and a lower CR rate (66% vs 83%; P =.01).

“Black AYA AML patients treated with intensive chemotherapy have inferior survival compared to White patients, and the disparity is mostly driven by the very young patients age 18-29 years,” Dr Larkin said. “The reasons for poor survival are undoubtedly multifactorial, as evidenced by higher early death rates, lower complete remission rates, and apparent lack of successful salvage.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Read more of Cancer Therapy Advisor’s coverage of the ASH 2021 meeting by visiting the conference page.

Reference

Larkin K, Nicolet D, Kelly B, et al. High early death rates, treatment resistance and short survival of Black adolescent and young adults (AYAs) with acute myeloid leukemia (AML) (Alliance). Presented at ASH 2021; December 11-14, 2021. Abstract 221.