Racial & Socioeconomic Disparities in Patients with B-Cell Prolymphocytic Leukemia

IF 2.5 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Journal of the National Medical Association Pub Date : 2024-08-01 DOI:10.1016/j.jnma.2024.07.057
Kingsley Chinonyerem Nnawuba MD, Samantha Robinson PhD, Obed Asare Hanna Jensen MD, PhD
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Abstract

Background

Leukemia refers to blood cell cancers that originates from the bone marrow. The prolymphocytic leukemia (PLL) subtype consists of the T-Cell prolymphocytic leukemia(T-PLL) and rarer B-Cell prolymphocytic leukemia(B-PLL) variant. B-PLL is harder to treat owing to cytogenetic abnormalities like MYC rearrangement and TP53 mutations. There have been limited studies about this disease, especially outcomes among different patient demographics.

Methods

The National Cancer Institute's Surveillance, Epidemiology, and End-Result (SEER) registry research database 17(2000 -2020) was used to explore and compare the outcomes for B-PLL in adult & Adolescent and Young Adult (AYA) patients. Univariate & multivariate analyses were performed to assess prognostic outcomes. A p-value <0.05 was considered statistically significant.

Results

A total of 608 deidentified patients were sampled (375 males and 233 females). Race and ethnicity was categorized to Hispanic & non-Hispanic. The non-Hispanic patients were further subdivided into White, Black, Asian, and Pacific Islanders. Socioeconomic status was associated with urban vs rural dwelling. Significant racial/ethnic differences (p<0.01) were seen in patients for this cancer type with regard to age group and living status. Specifically, there were significantly more Hispanic (all races) patients that were younger i.e., AYA than other racial/ethnic groups (p=.002). Additionally, non-Hispanic Black and White patients were more likely to die from B-PLL compared to other racial/ethnic groups (p=.007).

Discussion

Interesting differences were observed in the age, socioeconomic status, geographical area, and survival status among different race groups with B-PLL. Further research is warranted to characterize the demographic variables that may impact cancer care and survival.

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B 细胞前淋巴细胞白血病患者的种族和社会经济差异
背景白血病是指起源于骨髓的血细胞癌症。原淋巴细胞白血病(PLL)亚型包括T细胞原淋巴细胞白血病(T-PLL)和更罕见的B细胞原淋巴细胞白血病(B-PLL)变异型。B-PLL由于细胞遗传学异常(如MYC重排和TP53突变)而更难治疗。方法利用美国国家癌症研究所(National Cancer Institute)的监测、流行病学和最终结果(SEER)登记研究数据库17(2000 -2020),探讨和比较成人和青少年(AYA)患者的B-PLL治疗效果。对预后结果进行了单变量和多变量分析。结果共抽取了 608 名身份不明的患者(男性 375 人,女性 233 人)。种族和民族分为西班牙裔和非西班牙裔。非西班牙裔患者又分为白人、黑人、亚裔和太平洋岛民。社会经济地位与城市居民和农村居民有关。该癌症类型的患者在年龄组和生活状况方面存在明显的种族/人种差异(p<0.01)。具体来说,西班牙裔(所有种族)患者中,年龄较小的患者(即 AYA)明显多于其他种族/族裔群体(p=.002)。此外,与其他种族/族裔群体相比,非西班牙裔黑人和白人患者更有可能死于 B-PLL(P=.007)。讨论:在 B-PLL 患者的年龄、社会经济地位、地理区域和生存状况方面,不同种族群体之间存在着有趣的差异。有必要进一步研究可能影响癌症护理和生存的人口统计学变量。
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来源期刊
CiteScore
4.80
自引率
3.00%
发文量
139
审稿时长
98 days
期刊介绍: Journal of the National Medical Association, the official journal of the National Medical Association, is a peer-reviewed publication whose purpose is to address medical care disparities of persons of African descent. The Journal of the National Medical Association is focused on specialized clinical research activities related to the health problems of African Americans and other minority groups. Special emphasis is placed on the application of medical science to improve the healthcare of underserved populations both in the United States and abroad. The Journal has the following objectives: (1) to expand the base of original peer-reviewed literature and the quality of that research on the topic of minority health; (2) to provide greater dissemination of this research; (3) to offer appropriate and timely recognition of the significant contributions of physicians who serve these populations; and (4) to promote engagement by member and non-member physicians in the overall goals and objectives of the National Medical Association.
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