African Americans with blood cancer do not live as long as caucasians, despite equal care

A new analysis has found that among patients with chronic lymphocytic leukemia, African Americans more commonly present with advanced disease, and they tend to have shorter survival times than Caucasians despite receiving the same care. Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the results suggest that biological factors may account for some racial disparities in cancer survival.

Among cancer patients, minorities tend to have a worse prognosis than Caucasians for reasons that are unclear. In African American patients, lower socioeconomic status and limited access to high-quality care often can play a role, but some researchers propose that certain cancers can behave more aggressively in , which also can lead to worse outcomes.

Because (CLL), a type of , is rare in African Americans, investigators from The University of Texas MD Anderson Cancer Center in Houston and the Duke University Medical Center in Durham led a study that combined the two centers' experiences with African American and Caucasian patients. Their analysis included 84 African American patients and 1,571 non-black patients referred to the two centers. All patients, regardless of race, had access to healthcare services and received the same treatments. "We sought to isolate race as a from other known demographic and clinical prognostic parameters in CLL," explained Dr. Falchi.

The investigators found that while the time from diagnosis (made either incidentally or because of clinical symptoms) to referral was shorter for African Americans than Caucasian patients, African Americans were more likely to have CLL that was more advanced at the time of referral. Also, although African Americans responded as well to first-line therapy as Caucasian patients, their cancer progressed more rapidly and their survival was shorter. The inferior survival of African American patients persisted when patients were grouped according to factors related to the severity of their disease.

"These findings suggest that while inducing similarly high response rates, standard treatments do not overcome racial differences in outcome among patients with CLL," said Dr. Ferrajoli. She added that a number of questions remain unanswered. For example, do distinct biologic characteristics of African American patients with CLL account for the disparities seen in this study? And will these findings hold in the general population, where the impact of socioeconomic status may be more varied?

In an accompanying editorial, Christopher Flowers, MD, of Emory University in Atlanta, and Barbara Pro, MD, of Thomas Jefferson University in Philadelphia, noted that to adequately study disparities in leukemia, investigators will need to collect specimens and clinical data from patients to examine the potential impact of molecular and biologic markers. "Future studies in CLL can use this work as a cornerstone for investigating in this disease," they wrote.

More information: "Clinical characteristics, response to therapy and survival of African American patients diagnosed with chronic lymphocytic leukemia: joint experience of MD Anderson Cancer Center and Duke University Medical Center." Lorenzo Falchi, Michael J. Keating, Xuemei Wang, Catherine C. Coombs, Mark C. Lanasa, Sara Strom, William G. Wierda, and Alessandra Ferrajoli. Cancer; Published Online: July 8, 2013 DOI: 10.1002/cncr.28030

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Pepper and halt: Spicy chemical may inhibit gut tumors

1 hour ago

Researchers at the University of California, San Diego School of Medicine report that dietary capsaicin – the active ingredient in chili peppers – produces chronic activation of a receptor on cells lining ...

Expressive writing may help breast cancer survivors

3 hours ago

Writing down fears, emotions and the benefits of a cancer diagnosis may improve health outcomes for Asian-American breast cancer survivors, according to a study conducted by a researcher at the University of Houston (UH).

Taking the guesswork out of cancer therapy

9 hours ago

Researchers and doctors at the Institute of Bioengineering and Nanotechnology (IBN), Singapore General Hospital (SGH) and National Cancer Centre Singapore (NCCS) have co-developed the first molecular test ...

Brain tumour cells found circulating in blood

10 hours ago

(Medical Xpress)—German scientists have discovered rogue brain tumour cells in patient blood samples, challenging the idea that this type of cancer doesn't generally spread beyond the brain.

International charge on new radiation treatment for cancer

10 hours ago

(Medical Xpress)—Imagine a targeted radiation therapy for cancer that could pinpoint and blast away tumors more effectively than traditional methods, with fewer side effects and less damage to surrounding tissues and organs.

User comments