Staff Writer: Deileta Kamhunga
The survival rates of B-cell acute lymphoblastic leukemia (B-ALL) have been dramatically improved through relatively new therapies. One such therapy is CD19-directed chimeric antigen receptor T-cell (CART) therapy, which has improved survival rates, particularly in children with relapsed or refractory B-ALL. However, other external factors may also have a significant impact on the survival and outcomes of B-ALL in children. Socioeconomic factors, especially, may contribute to survival outcomes.
This retrospective cohort study, published in the Journal of Clinical Oncology for the 2022 ASCO Annual Meeting, presented new findings on the possible association between poverty and poor B-ALL outcomes. The research was conducted in pediatric patients treated on CD19 CART clinical trials or with tisagenlecleucel at Children’s Hospital of Philadelphia between 2012 and 2020. Household poverty was assessed through insurance status.
Ultimately, it was found that out of 206 patients, 36% were affected by household poverty, and about 25% were of lower Childhood Opportunity Index (COI). Low COI was associated with inferior relapse-free survival. However, no significant differences in overall survival by household poverty or low COI were found.
Instead, patients unexposed to household poverty or with high COI had a high disease burden when they presented to CART. More research is needed to determine how exactly COI is linked to relapse.
In closing, patient-reported social determinants of health may be an important factor when determining appropriate clinical interventions for B-ALL. It is crucial to take a multifactorial approach to overcome inequities in clinical care and disease outcomes [1].
Source:
[1] Newman, H., Li, Y., Liu, H., Tam, V., Myers, R. M., DiNofia, A. M., Callahan, C., White, C. M., Baniewicz, D., Kadauke, S., Diorio, C., Teachey, D. T., Rheingold, S. R., Getz, K. D., June, C. H., Aplenc, R., Maude, S. L., Grupp, S. A., Bona, K., & Leahy, A. E. B. (2022, June). Impact of socioeconomic status on survival after CD19 CART therapy [Poster discussion session]. 2022 ASCO Annual Meeting, Chicago, IL. https://meetings.asco.org/abstracts-presentations/209384
