Racial and ethnic disparities in acuity of presentation among children with newly diagnosed acute leukemia

Author:

Winestone Lena E.12ORCID,Getz Kelly D.3ORCID,Li Yimei34,Burrows Evanette5,Scheurer Michael E.6,Tam Vicky5,Gramatges M. Monica6,Wilkes Jennifer J.7,Miller Tamara P.89ORCID,Seif Alix E.410ORCID,Rabin Karen R.6ORCID,Fisher Brian T.11ORCID,Aplenc Richard410

Affiliation:

1. Division of Allergy, Immunology, and BMT University of California San Francisco (UCSF) Benioff Children's Hospital San Francisco California USA

2. Helen Diller Family Comprehensive Cancer Center, University of California San Francisco San Francisco California USA

3. Departments of Biostatistics, Epidemiology, & Informatics and Pediatrics Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania USA

4. Division of Oncology Children's Hospital of Philadelphia Philadelphia Pennsylvania USA

5. Department of Biomedical and Health Informatics Children's Hospital of Philadelphia Philadelphia Pennsylvania USA

6. Department of Pediatrics Division of Hematology‐Oncology Baylor College of Medicine, Texas Children's Hospital Houston Texas USA

7. Department of Pediatrics Division of Hematology/Oncology University of Washington School of Medicine Seattle Children's Hospital Seattle Washington USA

8. Division of Hematology/Oncology Emory University Atlanta Georgia USA

9. Aflac Cancer & Blood Disorders Center Children's Healthcare of Atlanta Atlanta Georgia USA

10. Center for Childhood Cancer Research Division of Oncology Children's Hospital of Philadelphia Philadelphia Pennsylvania USA

11. Division of Infectious Diseases Children's Hospital of Philadelphia Philadelphia Pennsylvania USA

Abstract

AbstractWe evaluated disparities in disease burden, organ dysfunction, vital signs, and timing of therapy in children newly presenting with acute leukemia. Among 899 patients with acute leukemia diagnosed at two large children's hospitals, a priori lab‐based definitions of high disease burden, infection risk, renal dysfunction, and coagulopathy were applied to electronic health record data. Black patients with acute myeloid leukemia had increased prevalence of elevated white blood cell count and uric acid; Black patients with acute lymphoblastic leukemia demonstrated increased prevalence of coagulopathy. Black patients’ presentation more frequently included multiple lab abnormalities consistent with advanced physiologic dysfunction. No differences were found in days to therapy initiation.

Funder

Alex's Lemonade Stand Foundation for Childhood Cancer

American Society of Hematology

American Cancer Society

Publisher

Wiley

Subject

Oncology,Hematology,Pediatrics, Perinatology and Child Health

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