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Impact of race/ethnicity and language preferences on pediatric ALL survival outcomes

Meghan Davitt1, Lisa Gennarini1, David Loeb1

  • 1Division of Pediatric Hematology, Oncology, Transplant and Cellular Therapy, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York, USA.

Cancer Medicine
|April 16, 2023
PubMed

Insights

Hispanic children with acute lymphoblastic leukemia (ALL) have better survival than Non-Hispanic Black children. Spanish language preference is linked to worse outcomes, highlighting a need for further research into these pediatric cancer disparities.

Area of Science:

  • Pediatric Oncology
  • Hematologic Malignancies
  • Health Disparities

Background:

  • Acute lymphoblastic leukemia (ALL) and acute lymphoblastic lymphoma (ALLy) are common pediatric cancers.
  • Ethnic and racial disparities exist in ALL/ALLy treatment toxicities and cure rates.
  • Despite survival improvements, aggressive disease leads to mortality in many children.

Purpose of the Study:

  • To investigate ethnic and racial disparities in all-cause mortality among pediatric ALL/ALLy patients.
  • To identify factors influencing survival differences in this population.

Main Methods:

  • Retrospective cohort analysis of 274 pediatric ALL/ALLy patients (2004-2021).
  • Cox Proportional Hazard regression modeling adjusted for key demographic and clinical variables.
  • Analysis included age, race/ethnicity, chemotherapy intensity, language, glucose, and hypertension.

Main Results:

  • Hispanic patients had a significantly lower risk of death (78% less likely) compared to Non-Hispanic Black patients.
  • Spanish language preference was associated with a 2.91 times higher risk of death compared to English speakers.
  • Hypertension and Hispanic ethnicity impacted death risk in English speakers but not Spanish speakers.

Conclusions:

  • Hispanic children with ALL/ALLy demonstrate improved survival outcomes relative to Non-Hispanic Black children.
  • Spanish language preference is a significant, novel predictor of poorer survival in pediatric ALL/ALLy.
  • Further studies are warranted to validate the association between language preference and survival outcomes.
Abstract

Keywords:
acute lymphoblastic leukemiaracial and ethnic disparitiessurvival outcomes

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