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Precision medicine and health disparities: The case of pediatric acute lymphoblastic leukemia

Wylie Burke1, Kenneth Thummel2

  • 1Department of Bioethics and Humanities, University of Washington, Seattle, WA.

Nursing Outlook
|July 8, 2019
PubMed

Insights

Disparities in pediatric acute lymphoblastic leukemia (ALL) persist, with African American children facing worse outcomes. Addressing treatment access and cost is key to reducing these health inequities.

Area of Science:

  • Oncology
  • Health Disparities Research
  • Genetics

Background:

  • Precision medicine's role in addressing population health disparities remains uncertain.
  • Pediatric acute lymphoblastic leukemia (ALL) serves as a case study for examining health inequities.

Purpose of the Study:

  • To evaluate disparities in pediatric acute lymphoblastic leukemia (ALL) between African American (AA) and European American (EA) children.
  • To assess the impact of genetic variations and treatment access on ALL outcomes.

Main Methods:

  • A literature-based evaluation of pediatric ALL cases in African American and European American children.
  • Analysis of incidence, relapse rates, prognostic indicators, environmental exposures, and genetic variants.

Main Results:

  • African American children exhibit lower ALL incidence but higher relapse rates and poorer prognostic indicators compared to European American children.
  • Environmental risk factors show small effect sizes, with insufficient data to determine their contribution to disparities.
  • Genetic variants influence treatment response and relapse rates, but improved care settings mitigated these disparities.

Conclusions:

  • Unequal access to effective treatment is a significant contributor to ALL disparities.
  • Precision medicine holds potential for defining effective treatments tailored to diverse patient populations.
  • Optimizing treatment protocols and eliminating financial barriers can reduce observed disparities in pediatric ALL outcomes.
Abstract

Keywords:
Childhood leukemiaHealth disparitiesPharmacogenomicsPrecision medicine

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