An investigation of toxicities and survival in Hispanic children and adolescents with ALL: Results from the Danaâ Farber Cancer Institute ALL Consortium protocol 05â 001
Kahn, Justine M.; Cole, Peter D.; Blonquist, Traci M.; Stevenson, Kristen; Jin, Zhezhen; Barrera, Sergio; Davila, Randy; Roberts, Emily; Neuberg, Donna S.; Athale, Uma H.; Clavell, Luis A.; Laverdiere, Caroline; Leclerc, Jean‐marie; Michon, Bruno; Schorin, Marshall A.; Welch, Jennifer J.G.; Sallan, Stephen E.; Silverman, Lewis B.; Kelly, Kara M.
2018-03
Citation
Kahn, Justine M.; Cole, Peter D.; Blonquist, Traci M.; Stevenson, Kristen; Jin, Zhezhen; Barrera, Sergio; Davila, Randy; Roberts, Emily; Neuberg, Donna S.; Athale, Uma H.; Clavell, Luis A.; Laverdiere, Caroline; Leclerc, Jean‐marie ; Michon, Bruno; Schorin, Marshall A.; Welch, Jennifer J.G.; Sallan, Stephen E.; Silverman, Lewis B.; Kelly, Kara M. (2018). "An investigation of toxicities and survival in Hispanic children and adolescents with ALL: Results from the Danaâ Farber Cancer Institute ALL Consortium protocol 05â 001." Pediatric Blood & Cancer 65(3): n/a-n/a.
Abstract
PurposeThis study compared the relative incidence of treatmentâ related toxicities and the eventâ free and overall survival between Hispanic and nonâ Hispanic children undergoing therapy for acute lymphoblastic leukemia (ALL) on Danaâ Farber Cancer Institute ALL Consortium protocol 05â 001.Patients and methodsSecondary analysis of prospectively collected data from a phase III multicenter study in children and adolescents of 1â 18 years with previously untreated ALL.ResultsBetween 2005 and 2011, 794 eligible patients enrolled on DFCI 05â 001, 730 of whom were included in this analysis (19% [NÂ =Â 150] Hispanic, 73% [NÂ =Â 580] nonâ Hispanic). Hispanic patients were more likely to be â ¥10 years of age (32%Â vs. 24%, PÂ =Â 0.045) at diagnosis. Toxicity analyses revealed that Hispanic patients had significantly lower cumulative incidence of bone fracture (PÂ <Â 0.001) and osteonecrosis (ON; PÂ =Â 0.047). In multivariable risk regression, the risk of ON was significantly lower in Hispanic patients â ¥10 years (HR 0.23; PÂ =Â 0.006). Hispanic patients had significantly lower 5â year eventâ free survival (EFS) (79.4%; 95% CI: 71.6â 85.2) and overall survival (OS) (89.2%; 95% CI: 82.7â 93.4) than nonâ Hispanic patients (EFS: 87.5%; 95% CI: 84.5â 90.0, PÂ =Â 0.004; OS: 92.7%; 95% CI: 90.2â 94.6, PÂ =Â 0.006). Exploratory analyses revealed differences between Hispanic and nonâ Hispanic patients in the frequency of common variants in genes related to toxicity or ALL outcome.ConclusionHispanic children treated for ALL on DFCI 05â 001 had fewer boneâ related toxicities and inferior survival than nonâ Hispanic patients. While disease biology is one explanatory variable for outcome disparities, these findings suggest that biologic and nonâ biologic mechanisms affecting drug delivery and exposure in this population may be important contributing factors as well.Publisher
Wiley Periodicals, Inc.
ISSN
1545-5009 1545-5017
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