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Comparable on-therapy mortality and supportive care requirements in Black and White patients following initial induction for pediatric acute myeloid leukemia.
Comparable on-therapy mortality and supportive care requirements in Black and White patients following initial induction for pediatric acute myeloid leukemia.
- Source :
-
Pediatric blood & cancer [Pediatr Blood Cancer] 2019 Apr; Vol. 66 (4), pp. e27583. Date of Electronic Publication: 2018 Dec 26. - Publication Year :
- 2019
-
Abstract
- Background: Black patients with acute myeloid leukemia (AML) are more likely to present with high acuity and consequently experience higher rates of induction mortality than white patients. Given the consistently identified racial disparities in overall survival (OS) among patients with AML, we aimed to evaluate whether there were sustained on-therapy racial differences in inpatient mortality, intensive care unit (ICU) requirements, or supportive care beyond initial induction.<br />Procedure: Within a retrospective cohort of 1239 children diagnosed with AML between 2004 and 2014 in the Pediatric Health Information System (PHIS) database who survived their initial course of induction chemotherapy, we compared on-therapy inpatient mortality, ICU-level care requirements, treatment course duration, cumulative length of hospital stay (LOS), and resource utilization after induction I by race.<br />Results: Over the period from the start of induction II through completion of frontline chemotherapy, there were no significant differences in mortality (adjusted odds ratios [OR], 1.01; 95% confidence intervals [CI], 0.41-2.48), ICU-level care requirements (adjusted OR, 0.93; 95% CI, 0.69-1.26), LOS (adjusted mean difference, 3.2 days; 95% CI, -2.3-9.6), or supportive care resource utilization for black patients relative to white patients. Course-specific analyses also demonstrated no differences by race.<br />Conclusion: Although black patients have higher acuity at presentation and higher induction mortality, such disparities do not persist over subsequent frontline chemotherapy treatment. This finding allows interventions aimed at reducing disparities to be directed at presentation and induction.<br /> (© 2018 Wiley Periodicals, Inc.)
- Subjects :
- Adolescent
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Leukemia, Myeloid, Acute ethnology
Leukemia, Myeloid, Acute mortality
Leukemia, Myeloid, Acute therapy
Male
Survival Rate
Black or African American
Critical Care
Databases, Factual
Disease-Free Survival
Length of Stay
White People
Subjects
Details
- Language :
- English
- ISSN :
- 1545-5017
- Volume :
- 66
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Pediatric blood & cancer
- Publication Type :
- Academic Journal
- Accession number :
- 30585685
- Full Text :
- https://doi.org/10.1002/pbc.27583