@article{2fac3b7752b84d16b0b8ccded8b5f71e,
title = "An investigation of toxicities and survival in Hispanic children and adolescents with ALL: Results from the Dana-Farber Cancer Institute ALL Consortium protocol 05-001",
abstract = "Purpose: This study compared the relative incidence of treatment-related toxicities and the event-free and overall survival between Hispanic and non-Hispanic children undergoing therapy for acute lymphoblastic leukemia (ALL) on Dana-Farber Cancer Institute ALL Consortium protocol 05-001. Patients and methods: Secondary analysis of prospectively collected data from a phase III multicenter study in children and adolescents of 1–18 years with previously untreated ALL. Results: Between 2005 and 2011, 794 eligible patients enrolled on DFCI 05-001, 730 of whom were included in this analysis (19% [N = 150] Hispanic, 73% [N = 580] non-Hispanic). Hispanic patients were more likely to be ≥10 years of age (32% vs. 24%, P = 0.045) at diagnosis. Toxicity analyses revealed that Hispanic patients had significantly lower cumulative incidence of bone fracture (P < 0.001) and osteonecrosis (ON; P = 0.047). In multivariable risk regression, the risk of ON was significantly lower in Hispanic patients ≥10 years (HR 0.23; P = 0.006). Hispanic patients had significantly lower 5-year event-free survival (EFS) (79.4%; 95% CI: 71.6–85.2) and overall survival (OS) (89.2%; 95% CI: 82.7–93.4) than non-Hispanic patients (EFS: 87.5%; 95% CI: 84.5–90.0, P = 0.004; OS: 92.7%; 95% CI: 90.2–94.6, P = 0.006). Exploratory analyses revealed differences between Hispanic and non-Hispanic patients in the frequency of common variants in genes related to toxicity or ALL outcome. Conclusion: Hispanic children treated for ALL on DFCI 05-001 had fewer bone-related toxicities and inferior survival than non-Hispanic patients. While disease biology is one explanatory variable for outcome disparities, these findings suggest that biologic and non-biologic mechanisms affecting drug delivery and exposure in this population may be important contributing factors as well.",
keywords = "Hispanic, acute lymphoblastic leukemia, ethnicity, outcomes, survival, toxicities",
author = "Kahn, {Justine M.} and Cole, {Peter D.} and Blonquist, {Traci M.} and Kristen Stevenson and Zhezhen Jin and Sergio Barrera and Randy Davila and Emily Roberts and Neuberg, {Donna S.} and Athale, {Uma H.} and Clavell, {Luis A.} and Caroline Laverdiere and Leclerc, {Jean Marie} and Bruno Michon and Schorin, {Marshall A.} and Welch, {Jennifer J.G.} and Sallan, {Stephen E.} and Silverman, {Lewis B.} and Kelly, {Kara M.}",
note = "Funding Information: The authors would like to thank the patients, families, physicians, nurses, research coordinators, and all others who participated in the data collection associated with this work. They would also like to thank the Dana-Farber Cancer Institute ALL Consortium for its contribution to this work. The patients described in this report were enrolled at the following Dana-Farber Cancer Institute (DFCI) Acute Lymphoblastic Leukemia Consortium sites: DFCI/Boston Children's Hospital (Boston, MA), Columbia University Medical Center, Morgan Stanley Children's Hospital of New York-Presbyterian (New York, NY), Hospital Sainte Justine (Montreal, QC, Canada), Le Centre Hospitalier de L'Universite Laval (Quebec City, QC, Canada), McMaster Children's Hospital (Hamilton, ON, Canada), San Jorge Children's Hospital (San Juan, PR), University of Rochester Medical Center (Rochester, NY), Hospital Ste. Justine (Montreal, Quebec, Canada), Hasbro Children's Hospital (Providence, RI), and Inova/Fairfax Hospital for Children (Falls Church, VA). This work was supported in part by funding from the National Institutes of Health (R25 CA094061) (to J.M.K.) and the St. Baldrick's Foundation (Supportive Care Research Award) (to P.D.C.). Clinical trial information for DFCI 05-001: ClinicalTrials.gov, number NCT00400946. Concept and design: J.M.K., P.D.C., T.M.B., K.E.S., L.B.S., and K.M.K; provision of study materials or patients: L.B.S., U.H.A., P.D.C., L.A.C., K.M.K., C.L., J.-M.L., B.M., M.A.S., and J.J.G.W; collection and assembly of data: J.M.K., P.D.C., T.M.B., K.E.S., L.B.S., and K.M.K; data analysis and interpretation: J.M.K., P.D.C., T.M.B., K.E.S., Z.J., D.S.N., S.B., R.D., E.R., S.E.S., L.B.S., and K.M.K; and manuscript writing and final approval of manuscript: all authors. Publisher Copyright: {\textcopyright} 2017 Wiley Periodicals, Inc.",
year = "2018",
month = mar,
doi = "10.1002/pbc.26871",
language = "English (US)",
volume = "65",
journal = "Medical and Pediatric Oncology",
issn = "1545-5009",
publisher = "Wiley-Liss Inc.",
number = "3",
}