Breaking Barriers in AML Care: Addressing Survival Disparities in Young Adults

A recent study, presented at the 2024 ASH Conference, examined survival rates among more than 17,000 adolescents and young adults (AYAs) aged 15 to 39 who were diagnosed with acute myeloid leukemia (AML) in the United States between 2004 and 2021. The research aimed to identify disparities based on race and sex and observe how these differences have evolved over time.

Take the time to watch the following video with primary investigator Erin Feliciano, an internal medicine resident passionate about understanding and overcoming healthcare disparities. She’ll explain why the study was conducted, what the results were, and future steps based on the data here: 

Key Findings

• Overall survival rates: Although survival rates for AYAs with AML have improved over time (with a 5-year overall survival increasing from ~55% to 66%), disparities persist among different groups.
• Sex-based differences: In both studied periods (2004-2013 and 2014-2021), females consistently had better survival rates than males. The difference was even higher in the more recent period (HR 0.89 versus HR 0.81).
• Racial disparities: Black patients had lower 5-year overall survival rates (52%) compared to white patients (~61%) in both eras. Unfortunately, this gap did not improve over time, indicating persistent racial disparities in survival outcomes.
• Other factors: Lack of insurance and the presence of additional health conditions were linked to poorer survival outcomes, highlighting the role of socioeconomic factors in patient prognosis.

Implications for Patients and Caregivers

This study underscores the importance of recognizing and addressing disparities in cancer care. While advancements in treatment have improved overall survival rates for AML, certain groups, particularly males and Black patients, continue to experience poorer outcomes.

Recommendations for Progress 

• Advocacy for equitable care: Healthcare workers, along with patients and caregivers, should actively advocate for equal access to high-quality care, regardless of race or sex.
• Awareness of socioeconomic factors: Care providers have a responsibility to help those diagnosed (and their families) understand that factors like insurance status and additional health conditions can impact survival. This may encourage patients to be more proactive in their treatment and seek comprehensive care.
• Support and resources: Engaging with support groups and resources tailored to specific communities can provide additional assistance and information.
• Understanding nuances: Proper training of healthcare providers should include the ability to take into account the nuances of this population. For example, young people could be parents to young children or be building a career to support themselves or their families, which could make it harder for them to choose between showing up for treatment and attending to their already-existing responsibilities. Working with this population to understand the nuances of the personal situation and seeking to provide answers for these dilemmas can be life-saving.

For more updates on AML treatments, survical outcomes, and progress in AML research, read here: AML News 

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Source:  

• Evolution of Survival Disparities Among Adolescents and Young Adults with AML in the US