For patients with acute myeloid leukemia (AML), non-Hispanic Black individuals have inferior survival compared with non Hispanic White individuals, with census tract measures accounting for most of the disparities in survival, according to a study published in Blood. Ivy Elizabeth Abraham, MD, and colleagues conducted a discrete survival analysis on 822 adults with AML from six urban cancer centers. The contribution of neighborhood measures of structural racism on racial/ethnic differences in survival was examined. Mediation analysis of the risk of leukemia death between groups was examined across composite variables. Mortality was higher for non-Hispanic Black and Hispanic patients versus non-Hispanic White patients. For leukemia death, nearly all disparities between non-Hispanic Black and non-Hispanic White and Hispanic and non-Hispanic White patients were accounted for by census tract measures. Additional mediators of survival disparities were treatment patterns, including induction intensity and allogeneic transplant, as well as treatment complications as assessed by ICU admission during induction chemotherapy.
