ASH 2021 | Enrollment characteristics/outcomes of Hispanic/Black AYA ALL patients on a U.S. intergroup trial

Approximately 40% of US adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) are Hispanic, and 7% are Black. Both groups tend to have poorer outcomes when compared to their white counterparts. Lori Muffly, MD, Stanford University Medical Center, Stanford, CA, analyzes enrollment patterns of Hispanic and Black AYAs in the Phase II CALGB 10403 study and compares survival relative to SEER data. Demographics were supplemented with patient-reported socioeconomic status information, and data from country-wide cancer registries were used to evaluate overall incidence and ethnic distribution of overall survival (OS). Hispanic enrollment was disproportionately low when compared to cancer registry data on Hispanics ALL incidence across states, probably because the enrollment was low or because the trial did not open in some of the states with a higher proportion of Hispanic citizens. Interestingly, Black AYAs were more likely to have T-ALL, while Hispanics showed a higher proportion of Ph-like B-ALL and rearrangements in CRFL2. The 3-year event-free survival (EFS) and OS for the whole cohort were 59.1% and 73.5%, respectively, with completion of therapy highest in Hispanic patients and OS also superior in this group, unlike SEER estimates. This analysis suggests that a closer matching of trial site selection to geographical or ethnic disease incidence may improve minority enrollment, and that superior survival of Hispanic patients indicates that clinical trial participation may mitigate ethnic-related disparities. This press briefing was recorded at the American Society of Hematology (ASH) 2021 Annual Meeting and Exposition in Atlanta, GA.