Division of Allergy, Immunology, and BMT, Department of Pediatrics, University of California San Francisco (UCSF) Benioff Children's Hospital, 550 16th Street, San Francisco, CA, 94158, USA.
Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, CA, USA.
Curr Hematol Malig Rep. 2019 Jun;14(3):179-186. doi: 10.1007/s11899-019-00515-x.
The aim of this review is to summarize the current literature on pediatric leukemia disparities with attention to not only racial and ethnic disparities, but also socioeconomic disparities. We focus on disparities in survival as well as other health-related outcomes, including end-of-life care and late effects.
While progress has been made in decreasing some disparities, most notably in pediatric acute lymphoblastic leukemia, disparities along many axes persist. Proposed etiologies include differences in the genomic alterations of the leukemia itself to differences in access to care that operate through socioeconomic status, insurance, and geographic location. As approaches to therapy become increasingly technical and complex, particular attention to the equitable distribution of these personalized therapeutic interventions is essential. Moving beyond simple descriptive studies to focus on mechanisms of existing disparities will allow for design of interventions to reduce or eliminate disparities in pediatric leukemia.
目的综述： 本篇综述的目的在于总结儿科白血病差异的现有文献，不仅关注种族和民族差异，还关注社会经济差异。我们专注于生存以及其他与健康相关的结果的差异，包括临终关怀和晚期效应。
最近的发现：虽然在减少某些差异方面已经取得了进展，尤其是在儿科急性淋巴细胞白血病方面，但在许多方面仍然存在差异。提出的病因包括白血病本身的基因组改变差异，以及通过社会经济地位、保险和地理位置等因素影响的获得医疗服务的差异。随着治疗方法变得越来越复杂和技术化，特别需要关注这些个性化治疗干预措施的公平分配。从单纯的描述性研究转向关注现有差异的机制，将有助于设计干预措施来减少或消除儿科白血病的差异。
