ASH 2024 | Real-world impact of HMA+VEN on AML survival in medically underserved areas

So the third abstract is number 5190, the disparities in AML survival in the targeted therapy era, the real-world evidence of enhanced equity of outcomes of patients with medically underserved areas, authored by our Moffitt group. So survival outcomes of elderly patients with AML have improved since the approval of venetoclax in the combination of the hypomethylating agents. These novel therapies in AML present promising opportunities to narrow the health care gaps for underserved patients as these treatments have become accessible in the community. However, there are challenges related to laboratory monitoring, transfusion support, and care coordination with these therapies. Currently, there is very little understanding of the impact of the recent advances in AML management on the outcome of patients residing in the locations with limited access to healthcare. The purpose of this study was to compare the characteristics, survival outcomes, and treatment patterns of patients residing in the federally designated medical underserved areas, the MUAs versus the non-MUAs and who received the frontline therapy with HMA venetoclax for AML at our institution. The MUA status was determined by using the online tool from the Health Resources and Services Administration. So we analyzed the 247 patients, 160 MUAs versus 87 non-MUAs with a median age similar between the two groups. With no significant differences in the performance status, ratio distributions, the disease risk categories between the two groups. The key finding of our project was the median OS survival was comparable at 11.1 months for MUA patients and 10 months for the non-MUA patients. The two years OS survival was numerically higher in the MUA groups. The allogeneic stem cell transplant was received by 12.5% of the MUA patients and 11.4% of the non-MUA patients, with most of the transplant occurring in the first complete remission. So our project highlights the role of the frontline therapy with HMA-Ven in improved overrall survival for AML patients regardless of their residence in the MUAs. So there are several limitations for our project. So the first limitation was that the study population did have access to the comprehensive academic center despite their MUA status, a factor that could have contributed to the comparable overall survival in the MUA groups. The second limitation was that our data set includes a small minority of non-white patients, and it doesn’t capture the intersectionality of the race and ethnicity within the MUA population sufficiently. More studies are needed to ascertain if novel therapy AML can deliver equitable outcomes for historically disadvantaged racial or ethnicity groups within the underserved areas. Thank you for your attention.

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