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ASH 2024 | Assessing disparities in a real-world cohort of patients with myelofibrosis
In this video, Anand Patel, MD, University of Chicago Medical Center, Chicago, IL, outlines the disparities observed among patients of different racial and ethnic backgrounds with myelofibrosis (MF). Dr Patel highlights that Hispanic and black patients in a Chicagoland real-world cohort had higher rates of primary myelofibrosis compared to white patients and that lower rates of JAK inhibitor administration and poorer overall survival were observed in black patients despite having similar rates of high-risk disease. Dr Patel suggests that a lack of appropriate risk scoring systems and insurance status may be key drivers of these disparities. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
Yeah, so one of the projects I’ve had the pleasure of being a part of is a large Chicagoland consortium focused on disparities in myeloid malignancies. So we’ve done previous work in acute myeloid leukemia demonstrating the impact of structural racism and air pollutant exposure in terms of drivers of disparate outcomes in patients with AML. We wanted to transition a lot of that work into looking at patients with myelofibrosis as well...
Yeah, so one of the projects I’ve had the pleasure of being a part of is a large Chicagoland consortium focused on disparities in myeloid malignancies. So we’ve done previous work in acute myeloid leukemia demonstrating the impact of structural racism and air pollutant exposure in terms of drivers of disparate outcomes in patients with AML. We wanted to transition a lot of that work into looking at patients with myelofibrosis as well. So ultimately, a cohort of about 500 patients was identified. And within that cohort, we looked at patients who identified as non-Hispanic white, non-Hispanic black or Hispanic. And what we found was across this cohort, our Hispanic and black patients had higher rates of primary myelofibrosis as compared to secondary myelofibrosis when compared to our white patients. We also found that when using our traditional risk scores, it seems that risk stratification was fairly similar based on race ethnicity.
The major drivers of disparity that we found was JAK inhibitor receipt. So black patients had significantly lower rates of receipt of JAK inhibitors, despite having similar rates of high-risk disease when compared to white and Hispanic patients. We did find similar rates of allogeneic transplant, which is quite encouraging within this cohort. And then lastly, when controlling for age and gender, we found that our black patients had poorer overall survival when compared to our white and Hispanic patients, suggesting that even if we’re looking at cohorts of patients that have similar risk disease based on our traditional risk scores, there are still barriers to care that are popping up, whether it’s receipt of JAK inhibitors or whether it’s that these risk scores, which have been developed in largely homogenous populations, may not actually be the best for more diverse patient populations. So further work is ongoing to characterize whether risk stratification using things such as DIPSS and MIPSS is applicable for black and Hispanic patients and whether things like insurance status and census tract further influence the outcome of these patients.
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Disclosures
Sumitomo: Research Funding; Bristol Myers Squibb: Honoraria; Sobi: Honoraria; AbbVie: Honoraria; Pfizer: Research Funding; Kronos Bio: Research Funding.
