Rubnitz Jeffrey E, Lensing Shelly, Razzouk Bassem I, Pounds Stanley, Pui Ching-Hon, Ribeiro Raul C
Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Pediatr Blood Cancer. 2007 Jan;48(1):10-5. doi: 10.1002/pbc.20878.
The association between race and outcome of treatment for childhood acute myeloid leukemia (AML) has not been adequately studied.
We compared the clinical characteristics, biological features, and outcomes between white and black children with AML who were treated on five consecutive clinical protocols (1980-2002) at St. Jude Children's Research Hospital. We used proportional hazards modeling to investigate the relation between race and outcome.
We observed no statistically significant differences between the 229 white and 58 black patients in clinical characteristics, FAB subtype, cytogenetic features, or outcome. There were no significant differences in event-free survival (EFS) or overall survival (OS) between the two race groups in individual clinical trials or in all studies combined. For the study group as a whole, the 5-year survival estimate was 39.2% +/- 3.6% for white patients and 33.8% +/- 6.5% for black patients. However, on our most recent trial (AML-97), there was a trend towards inferior outcome among black patients: the 5-year survival estimates were 55.6% +/- 12.3% and 27.3% +/- 13.5% for whites and blacks, respectively.
Although we detected no differences in treatment outcome between white and black children with AML over the entire study period, black children appear to have worse outcomes than white children during more recent studies. Improved treatment is needed for all children with AML.
种族与儿童急性髓系白血病（AML）治疗结果之间的关联尚未得到充分研究。
我们比较了在圣裘德儿童研究医院连续五个临床方案（1980 - 2002年）中接受治疗的白人及黑人AML儿童的临床特征、生物学特性和治疗结果。我们使用比例风险模型来研究种族与治疗结果之间的关系。
我们观察到229名白人患者和58名黑人患者在临床特征、FAB亚型、细胞遗传学特征或治疗结果方面无统计学显著差异。在各个临床试验或所有研究合并分析中，两个种族组在无事件生存期（EFS）或总生存期（OS）方面均无显著差异。对于整个研究组，白人患者的5年生存估计值为39.2%±3.6%，黑人患者为33.8%±6.5%。然而，在我们最近的试验（AML - 97）中，黑人患者的治疗结果有较差的趋势：白人和黑人的5年生存估计值分别为55.6%±12.3%和27.3%±13.5%。
尽管在整个研究期间我们未发现白人及黑人AML儿童在治疗结果上存在差异，但在最近的研究中，黑人儿童的治疗结果似乎比白人儿童更差。所有AML儿童都需要改进治疗方法。
