Disparities in acute lymphoblastic leukemia risk and survival across the lifespan in the United States of America

Acute lymphoblastic leukemia (ALL) most less in and young adults (AYAs) is among older adults. The 5-year survival of is above 90% in children, drops significantly in AYAs, and over half of ALL-related deaths occur in older adults. In addition to diagnosis age, the race/ethnicity of patients consistently shows association with ALL incidence and outcomes. we review the racial/ethnic disparities in ALL incidence and outcomes, discuss how these vary across the age spectrum, and examine the potential causes of these disparities. In the United States, the incidence of ALL is highest in Hispanics/Latinos and lowest in Black individuals across all age groups. ALL incidence is rising fastest in Hispanics/Latinos, in AYAs. In addition, survival is worse in Hispanic/Latino or Black ALL patients compared to those who are non-Hispanic White. Different molecular subtypes of ALL show heterogeneities in incidence rates and survival outcomes across age groups and race/ethnicity. Several ALL risk variants are associated genetic and demonstrate different risk allele frequencies and/or effect sizes across non-genetic socioeconomic to all influence the disparities in ALL risk and survival. Further studies are needed to investigate the potential joint effects and interactions of genetic and environmental risk factors. survival in Hispanic/Latino and Black patients with ALL advances in precision medicine approaches,