美国确诊的 CLL/SLL 患者的种族和民族特征及治疗效果。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-05-20 DOI:10.1159/000538836
Debora S Bruno, Manoj Khanal, Xiaohong I Li, Maricer P Escalon, Katherine B Winfree, Lisa M Hess
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引用次数: 0

摘要

背景 本研究旨在比较后共价布鲁顿酪氨酸激酶抑制剂(cBTKi)治疗时代不同种族和族裔患者的治疗效果。方法 利用全国范围内的电子健康记录(EHR)生成的去标识数据库,其中包括 2013-2022 年期间诊断为 CLL 并接受系统治疗的患者。在未调整分析(卡普兰-梅耶法)和调整分析(Cox比例危险回归)中,对cBTKi疗法的使用、下一次治疗或死亡时间(TTNT-D)和总生存率(OS)按种族进行了比较。结果 本研究共纳入 4572 名白人(71.8%)和 558 名黑人(8.8%)CLL 患者;其中 270 名患者为西班牙裔或拉丁裔(4.2%)。与白人患者相比,黑人患者明显更年轻,女性患者更多,疾病处于晚期,社会经济地位(SES)更低,免疫球蛋白重链基因(IGHV)未突变的可能性更大,接受过 cBTKi 治疗的可能性更大(均 p≤0.002)。不同种族的 SES 也有明显差异。在未经调整或调整后的分析中,TTNT-D 和 OS 因种族而异(均 p>0.05)。结论 在未调整分析和调整分析中,TTNT-D 和 OS 没有种族差异。尽管基线特征存在差异,但这些数据并未发现在引入 cBTKi 疗法后的时代存在种族医疗保健差异。
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Racial and Ethnic Characteristics and Outcomes of Patients Diagnosed with CLL/SLL in the USA.

Introduction: This study was designed to compare outcomes among patients by race and ethnicity in the post-covalent Bruton tyrosine kinase inhibitor (cBTKi) treatment era.

Methods: A nationwide electronic health record (EHR)-derived de-identified database was utilized that included patients diagnosed with CLL from 2013 to 2022 who received systemic therapy for their disease. Use of cBTKi therapy, time to next treatment or death (TTNT-D), and overall survival (OS) were compared by race in unadjusted (Kaplan-Meier method) and adjusted analyses (Cox proportional hazards regression).

Results: This study included 4,572 White (71.8%) and 558 Black (8.8%) patients with CLL; 270 were Hispanic or Latino (4.2%). Patients who were Black were significantly younger, more were female, had later stage disease, were of lower socioeconomic status (SES), and were more likely to have unmutated immunoglobulin heavy chain gene (IGHV) and to have received cBTKi therapy than White patients (all p ≤ 0.002). SES was also significantly different by ethnicity. TTNT-D and OS were not different by race in either unadjusted or adjusted analyses (all p > 0.05).

Conclusion: In unadjusted and adjusted analyses, TTNT-D and OS were not different by race. These data did not identify racial healthcare disparities in the era following the introduction of cBTKi therapy despite differences in baseline characteristics.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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