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ASH 2021 | Racial/Ethnic/Socioeconomic factors can lead to disparities in outcome among children with ALL

Health disparities greatly affect racial, ethnic, and socioeconomically disadvantageous groups, and they need to be identified. Although outcomes in childhood acute lymphoblastic leukemia (ALL) have improved, Sumit Gupta, MD, Institute for Health Policy, Evaluation and Management, University of Toronto, Toronto, ON, Canada, discusses a study in which the aim was to identify the persistent inequalities by the variables mentioned above. Patients were grouped according to ethnicity categories (white, Hispanic, black, Asian, other) and socioeconomic status (US public health insurance, US private insurance, non-US universal health insurance); event-free survival (EFS), overall survival (OS), and disease prognosticators were compared. The large cohort study showed greater 5-year EFS in the non-Hispanic white group versus Hispanic or non-Hispanic Black groups. Non-US patients had the best outcomes, followed by US private insurance and US public insurance patients. Interestingly, the addition of disease prognosticators and socioeconomic status attenuated the EFS outcomes in the Hispanic group but not in the non-Hispanic Black group, whereas the addition of ethnicity and disease prognosticators attenuated the EFS outcomes in the non-US universal health insured patients but not in the US public health insurance group. Dr Gupta concludes that disparities by ethnicity and socioeconomic status persist for various reasons, and that more work is needed to identify specific drivers for these disparities. This press briefing was recorded at the American Society of Hematology (ASH) 2021 Annual Meeting and Exposition in Atlanta, GA.