Black/Hispanic patients with TP53 mutation (m) acute myeloid leukemia (AML) had worse overall survival (OS) compared with White patients, according to study results presented by Talha Badar, MBBS, MD, at the 2022 American Society of Clinical Oncology (ASCO) Proceedings—Hematologic Malignancies at ASCO’s Annual Meeting
To compare differences in disease characteristics and clinical outcome, Dr. Badar and colleagues conducted a multicenter study of 304 patients with TP53m AML. Participants were divided by race in those who were White (N= 240) or Black/Hispanic (N=64). “We grouped Black and Hispanic together as the number of patients were small in each group and our aim was to evaluate outcomes in underrepresented races/ethnicities,” Dr. Badar wrote.
A Higher Percentage of Blacks/Hispanics Had Diabetes
Black/Hispanic patients (23%) had a notably higher percentage of diabetes mellitus when compared with White patients (14%; P=0.02). Additionally, a higher proportion of Black/Hispanic patients had therapy-related AML (33% vs 20%, P=0.03), co-mutations (70% vs 57%, P=0.02), and complex cytogenetics (98% vs 87%, P=0.003).
However, the percentages of patients receiving a hypomethylating agent plus venetoclax (29% vs 20%, P=0.20) or CPX-351 (22% vs 20%, P=0.13) were comparable between White and Black/Hispanic patients, respectively.
Blacks/Hispanics Received Considerably More Supportive Care
More than four times the percentage of Black/Hispanic patients received supportive care compared with White patients (17% vs 4%, P= 0.002), whereas White patients had higher rates of complete remission with or without count recovery (25% vs 19%, P=0.07). Compared with White patients (16%), fewer Black/Hispanic patients (6%) received allogeneic stem cell transplantation (alloHCT;P=0.01).
In White and Black/Hispanic patients, median event-free survival times were 2 months (95% CI;1.52-2.41) and 2.5 months (95% CI:1.62-3.31), respectively (P=0.71). For Black/Hispanic patients, the median OS was shorter (6.37 month [95% CI:2.88-9.85]) than for Whites (6.90 months [95% CI:5.55-8.24] [P=0.009]).
“Potential drivers of this disparity include lower alloHCT rates, higher rates of patients receiving supportive care, and higher-risk disease in Black/Hispanic patients,” Dr. Badar and team wrote.