急性髓性白血病随机试验中的种族和年龄差异:系统性审查和元分析
Nathalie Loeb1, Olivia Katsnelson2, Anshika Jain1
1Department of Internal Medicine, McMaster University, Hamilton, ON, Canada.
Blood neoplasia
|June 2, 2025
概括
种族和民族少数群体,特别是西班牙裔和亚洲裔患者,在急性髓性白血病 (AML) 临床试验中代表性不足. 虽然种族报告的数量有所增加,但在入学率上仍然存在显著的差异,这影响了公平的护理.
科学领域:
- 血液学 血液学 血液学
- 临床试验 临床试验
- 健康差异 在健康上的差异
背景情况:
- 在急性髓性白血病 (AML) 发病率和生存率方面存在显著的种族和民族差异.
- 了解随机对照试验 (RCT) 的招生模式对于改善在AML治疗中获得护理和试验的进行至关重要.
- 以前的研究表明,少数群体在癌症临床试验中的代表性可能不足.
研究的目的:
- 系统地审查和分析成年AMLRCT中种族/民族少数群体和老年人的入学情况.
- 使用入学发病率比率 (EIR) 与美国人口发病率相比,量化试验参与的差异.
- 根据试验阶段和地理位置,检查报告种族/种族和入学数量的趋势.
主要方法:
- 从开始到2023年6月,对成年AML疾病修饰疗法的MEDLINE索引RCT进行系统文献综述.
- 选了7759个标题/摘要和157个完整文本,结果包括了90个研究.
- 对招生发病率比率 (EIRs) 的元分析,以将试验参与者比例与美国人口发病率进行比较,以种族/种族小组和65岁或以上的年龄为准.
主要成果:
- 只有23.3%的试验报告了种族/种族,28%报告年龄≥65岁.
- 西班牙裔 (EIR 0.28) 和亚洲裔 (EIR 0.16) 患者的比例明显低;白人患者 (EIR 1.23) 的比例过高.
- 在过去的10年中,报告种族的试验比例显著增加 (46.2%与19.5%相比),在20年中,少数民族入学率相应增加.
结论:
- 尽管最近报告和少数群体参加急性髓性白血病 (AML) 临床试验的情况有所改善,但西班牙裔和亚洲裔人口的代表性仍然不足.
- 这些招生差异凸显了需要有针对性的战略,以确保公平参与AML研究.
- 持续监测和报告临床试验中的人口数据对于解决AML治疗中的健康不平等至关重要.
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