Introduction
Racial disparities in outcomes of children with acute lymphoblastic
leukemia treated from late 1970’s until 2014 have been well documented
with Black, Hispanic and Native American children having lower overall
survival compared to White non-Hispanic patients. (1-4). Similarly,
racial and ethnic differences in pediatric acute myeloid leukemia have
also been observed with inferior survival observed among Black and
Hispanic children compared to White non-Hispanic children.(5).Bhatia
postulated that causes of these disparities in outcomes in children with
cancer are multifactorial and include advanced stage at diagnosis,
disease biology, poor treatment response, non adherence to therapy,
health behaviors, lower socio-economic status, differences in enrollment
in upfront clinical trials and differences in health insurance (6).
Analysis of a large Center for International Blood and Marrow Transplant
Registry (CIBMTR) cohort of pediatric and adult patients with HM,
transplanted between 1995 and 2004 who received HCT from unrelated
donors, indicated worse overall survival of African-American HCT
recipients, compared to Whites and the difference was not fully
explained by transplant-related factors or socio-economic status
emphasizing again a complex, multifactorial etiology of those
differences.(7)
Given the paucity of data on the impact of race on outcomes after HCT in
children, we analyzed and present data from a contemporary cohort of
children receiving first allogeneic HCT for hematologic malignancies in
5 Florida pediatric HCT centers between 2010 and 2019.