Study shows structural racism can result in poorer leukemia outcomes

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Blacks and Hispanics suffering from myeloid leukemia in the Chicago metropolitan area are more likely to die from the disease than their white Hispanic counterparts, with a 59% and 25% higher risk, respectively, according to a new study led by the University of Illinois at Chicago. researchers.

In a study published in the journal BloodThe researchers studied how systemic violence — rural, in which social, economic and political systems continue to exist — could set the stage for poorer outcomes in patients with AML.

“This is the first study to combine individual clinical and disease data with demographic data on the affluence, vulnerability and segregation rates of the areas in which patients live and to study how these areas interact to influence outcomes for patients. fine with AML, “said Dr. Irum Khan, professor of oncology at Illinois College of Medicine and lead author.

She added that the study expands on the work of Garth Rauscher, a professor of veterinary science at the UIC School of Public Health, whose research identifies the neighborhood as a powerful factor contributing to diversity and written in AML for many years.

Such systemic violence, or injustice, is thought to expose the public to particular risk factors that lead to increased morbidity, reduced access. health care and short life. In this case, it is expected to contribute to racial / ethnic differences in the specific life cycle of leukemia, Khan said.

Khan and her team analyzed data from medical information of 822 patients aged 18 to over 60 who were diagnosed with AML at one of the six university cancer centers in the Chicago area between 2012 and 2018. Researchers collected data on sex, color race or ethnicity, age at diagnosis, with each other. health condition, The health insurance status and features of their cancer cells that suggest better or worse. They also collect U.S. census data about the neighborhoods my patients live in and classify those neighborhoods by segregation, affluence or severity.

A total of 497 patients identified themselves as white Hispanic; 126 as Hispanic Blacks; 117 as Hispanic; and 82 as other or unknown species. There were 445 men and 377 women in the study.

Blacks and Hispanics were more likely than whites to live in isolated, underprivileged villages. Early treatment for leukemia patients showed a high incidence of chemotherapy in Hispanic patients, probably related to their younger age and morbidity, but similar rates were shown among black and white patients, according to the study.

Interestingly, Khan said, Hispanic and non-Hispanic patients had the highest number of treatment complications, measured by intensive care unit during primary chemotherapy — 30% and 27%, respectively respectively, compared to Hispanic white patients at 22%. Patients Black and non-Hispanic patients had a lower risk of genetic transplantation than white and Hispanic patients.

After adjusting to the age of the patients, sex and the health care center where they were treated, the researchers found that neighborhood affluence, vulnerability and segregation were all important predictors of leukemia death. Studies to quantify the impact of different genetically modified genes- and specific therapies and local impairments suggest that the census can account for almost all racial differences in AML mortality, according to the study.

When statistical differences were eliminated, the risk of death in Black patients decreased from 60% to 4%.

Non-Hispanic Blacks are more likely than other species to have AML with high viral load. This suggests that further research is needed to determine whether living in less affluent areas is related to environmental factors that may increase the risk of developing complex AML strains.

Treatment for AML has increased significantly for individual patients over the past decade. However, there is a gap in the inclusion of my patients in public health check-ups, which is why these items need to be examined, Khan said.

“We focus on our efforts to balance therapies for the health of the patient, and the reactions of the cancer cells,” Khan said. “But no one cares about the third area in this Venn design, which is the factors that ensure public health, and the individual and the region, which represents the development of their experiences – access to food, access to safe havens. safe living and working, transportation, access to hospital care when needed. ”

“Our collaborative work of reviewing real-world data shows that the integration of improved public safety measures into clinical care can significantly contribute to narrowing differences in the life cycle of leukemia,” he said. ji Khan.

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Learn more:
Ivy Elizabeth Abraham et al, Racism is a mediating factor in Myeloid Outbreaks, Blood (2022). DOI: 10.1182 / blood.2021012830

Press Release:

hintStudies show racism is likely to have the lowest risk of leukemia (2022, March 7) retrieved 7 March 2022 from leukemia-outcomes.html

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