How Race, Income, and Access to Care impact AML Outcomes

How are racial and socioeconomic factors linked to outcomes in AML?

Recent findings from two studies presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting explore how race, income, and access to care affect survival and hospital readmissions in people with acute myeloid leukemia (AML).  In this article, you’ll learn how these factors may cause gaps in care and influence treatment outcomes.

Race and survival differences in secondary AML

In one study, researchers analyzed data from over 8,000 people with secondary acute myeloid leukemia (sAML), a form of AML that develops after another blood disorder or cancer therapy. This type includes:  AML with myelodysplasia-related changes (AML-MRC) and therapy-related AML (t-AML).

Both of these diagnoses are known for having worse outcomes than other types of AML.

The median age at diagnosis was 70 and most of the people were between 61 and 80 years old. Most people were White (84%), followed by Black (7.5%) and Asian or Pacific Islander (7.4%). About 9% were Hispanic.

When looking at survival rates, Black patients had a shorter average survival (13.3 months) than White (15.6 months), Asian or Pacific Islander patients (18.6 months) or Native American (14.3 months). After adjusting for factors like age and disease type, Black patients had 19.5% higher risk of death compared to White patients. These findings suggest that race may be linked to differences in access to care, treatment responses, or other health factors. Recognizing this can help guide efforts to make care more equitable for all AML patients.

Better outcomes in therapy-related AML vs. AML-MRC

The study also showed that people with therapy-related AML had a 13% lower risk of death than those with AML-MRC. Although both subtypes are considered high-risk, each subtype may affect treatment plans and expectations for survival, highlighting the importance of close monitoring and personalized care plans for older adults with sAML.

Who gets readmitted after transplant and why?

A second study reviewed hospital readmissions within 30 days of undergoing allogeneic hematopoietic stem cell transplant for AML. Of the nearly 16,000 patients included, around 30% were readmitted within a month.

The most common reasons for readmission were:

• Infections (34%) 
• Gastrointestinal or liver problems (10%) 
• Active AML (5%) 
• Kidney issues (5%)

Readmission was more likely among people with lower incomes, those with Medicare instead of private insurance, and those with certain medical conditions such as chronic kidney disease, acute graft-versus-host disease, and depression. Readmissions can add stress for patients and increase medical costs. 

Patients discharged with home-health care were less likely to be readmitted, suggesting that extra support after leaving the hospital may reduce complications.

What These Findings Mean for AML Patients

These studies reveal two key things:

1. Race and socioeconomic status may be linked to differences in access to care and other factors that affect how long people with AML live and how often they return to the hospital.
2. Certain subtypes and complications increase the risks, especially in older adults or those with underlying health problems.

For patients, this highlights the value of asking care teams about support resources after treatment and discussing any financial or social barriers to care. It also emphasizes the need for care systems to address these gaps by providing tailored services, especially for high-risk groups.

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Source: 

• Socioeconomic and clinical predictors of 30-day readmissions in AML patients undergoing allogeneic stem cell transplantation.
• Racial disparities and survival outcomes in secondary acute myeloid leukemia: A SEER-based analysis.