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Genomics of racial and ethnic disparities in childhood acute lymphoblastic leukemia
Joshua Yew-Suang Lim1, Smita Bhatia, Leslie L Robison
1Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Insights
Racial and ethnic disparities persist in childhood acute lymphoblastic leukemia (ALL) outcomes, with Hispanic children facing higher risks and lower survival rates. Understanding the biological and environmental causes is crucial for developing targeted interventions to reduce these health inequities.
Area of Science:
- Pediatric Oncology
- Health Disparities Research
- Cancer Biology
Background:
- Childhood acute lymphoblastic leukemia (ALL) cure rates have significantly improved.
- However, not all pediatric populations have equally benefited from these advancements.
- Persistent racial and ethnic disparities exist in ALL incidence and treatment outcomes.
Purpose of the Study:
- To review current knowledge on population variations in childhood ALL.
- To discuss genetic and non-genetic factors contributing to ALL disparities.
- To highlight potential therapeutic strategies for mitigating these disparities.
Main Methods:
- Literature review of studies on childhood ALL incidence and outcomes.
- Analysis of population variation data.
- Synthesis of research on genetic and environmental influences.
- Identification of therapeutic interventions.
Main Results:
- Hispanic children exhibit an elevated risk of developing ALL.
- Hispanic children have among the lowest survival rates post-ALL therapy.
- A significant knowledge gap exists regarding the biological basis of ALL disparities.
Conclusions:
- Addressing racial and ethnic disparities in childhood ALL is critical for equitable care.
- Further research into the underlying biological mechanisms of ALL disparities is needed.
- Targeted interventions are essential to improve outcomes for underrepresented minority groups.
Abstract:
Although the cure rates of childhood acute lymphoblastic leukemia (ALL) have improved dramatically in the past 40 years, not all children have benefited equally from this impressive progress. Racial and ethnic disparities in the incidence and treatment outcome of childhood ALL persist, with Hispanic children having an elevated risk of developing ALL and one of the lowest survival rates after ALL therapy. A critical barrier to progress is the lack of an understanding of the causes of ALL disparities, particularly racial and ethnic differences in ALL biology. In this review, the authors summarize the current knowledge on population variation in childhood ALL incidence and treatment outcome, discuss the contributing genetic and nongenetic variables, and highlight possible therapeutic interventions to mitigate disparities in ALL.
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