Journal article
An investigation of toxicities and survival in Hispanic children and adolescents with ALL: Results from the Dana-Farber Cancer Institute ALL Consortium protocol 05-001
Pediatric blood & cancer, Vol.65(3), pp.e26871-n/a
03/01/2018
DOI: 10.1002/pbc.26871
PMCID: PMC5766393
PMID: 29090520
Abstract
PurposeThis study compared the relative incidence of treatment-related toxicities and the event-free and overall survival between Hispanic and non-Hispanic children undergoing therapy for acute lymphoblastic leukemia (ALL) on Dana-Farber Cancer Institute ALL Consortium protocol 05-001.
Patients and methodsSecondary analysis of prospectively collected data from a phase III multicenter study in children and adolescents of 1-18 years with previously untreated ALL.
ResultsBetween 2005 and 2011, 794 eligible patients enrolled on DFCI 05-001, 730 of whom were included in this analysis (19% [N=150] Hispanic, 73% [N=580] non-Hispanic). Hispanic patients were more likely to be 10 years of age (32%vs. 24%, P=0.045) at diagnosis. Toxicity analyses revealed that Hispanic patients had significantly lower cumulative incidence of bone fracture (P<0.001) and osteonecrosis (ON; P=0.047). In multivariable risk regression, the risk of ON was significantly lower in Hispanic patients 10 years (HR 0.23; P=0.006). Hispanic patients had significantly lower 5-year event-free survival (EFS) (79.4%; 95% CI: 71.6-85.2) and overall survival (OS) (89.2%; 95% CI: 82.7-93.4) than non-Hispanic patients (EFS: 87.5%; 95% CI: 84.5-90.0, P=0.004; OS: 92.7%; 95% CI: 90.2-94.6, P=0.006). Exploratory analyses revealed differences between Hispanic and non-Hispanic patients in the frequency of common variants in genes related to toxicity or ALL outcome.
ConclusionHispanic children treated for ALL on DFCI 05-001 had fewer bone-related toxicities and inferior survival than non-Hispanic patients. While disease biology is one explanatory variable for outcome disparities, these findings suggest that biologic and non-biologic mechanisms affecting drug delivery and exposure in this population may be important contributing factors as well.
Details
- Title: Subtitle
- An investigation of toxicities and survival in Hispanic children and adolescents with ALL: Results from the Dana-Farber Cancer Institute ALL Consortium protocol 05-001
- Creators
- Justine M. Kahn - Columbia University Irving Medical CenterPeter D. Cole - Albert Einstein College of MedicineTraci M. Blonquist - Harvard UniversityKristen Stevenson - Harvard UniversityZhezhen Jin - Columbia University Irving Medical CenterSergio Barrera - University of MinnesotaRandy Davila - University of California, DavisEmily Roberts - University of Michigan–Ann ArborDonna S. Neuberg - Harvard UniversityUma H. Athale - McMaster UniversityLuis A. Clavell - Boston Children's HospitalCaroline Laverdiere - Université de MontréalJean-Marie Leclerc - Université de MontréalBruno Michon - Université LavalMarshall A. Schorin - Inova Fairfax HospitalJennifer J. G. Welch - Brown UniversityStephen E. Sallan - Harvard UniversityLewis B. Silverman - Harvard UniversityKara M. Kelly - Columbia University Irving Medical Center
- Resource Type
- Journal article
- Publication Details
- Pediatric blood & cancer, Vol.65(3), pp.e26871-n/a
- Publisher
- Wiley
- DOI
- 10.1002/pbc.26871
- PMID
- 29090520
- PMCID
- PMC5766393
- ISSN
- 1545-5009
- eISSN
- 1545-5017
- Number of pages
- 11
- Grant note
- R25 CA094061 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA R25CA094061 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) St. Baldrick's Foundation
- Language
- English
- Date published
- 03/01/2018
- Academic Unit
- Biostatistics
- Record Identifier
- 9984274822402771
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