Medically reviewed by Dr. Brian Koffman
The Bottom Line:
There continue to be disparities in survival based on race and income level among patients with chronic lymphocytic leukemia (CLL) / small lymphocytic lymphoma (SLL). Black patients and patients with low income had higher death rates and shorter survival than White patients and patients with higher income.
Who Performed the Research and Where Was it Presented:
Dr. Zhaohui Su from Ontada (part of McKesson Corporation) and colleagues presented the results at the American Society for Hematology (ASH) Annual Meeting 2023.
Background:
It is well known that there are racial and socioeconomic disparities in healthcare, and prior research has documented this in patients with CLL / SLL. Previous research presented at ASH 2022 demonstrated Persistent Racial/Ethnic, Sex, and Income Disparities in Overall Survival in CLL Patients. The current study sought to provide updated data in the era of targeted therapies using real-world data collected in a large community oncology setting in the US.
Methods and Participants:
This study used electronic health record data from CLL patients treated in US community oncology practices between 2015 and 2023.
Results:
- The study included 12,253 patients with CLL.
- Sixty percent of patients were male, and 40% were female.
- The vast majority of patients (91%) were White, 5% were Black, and 4% were other races.
- At the initial diagnosis, significantly more Black patients had Rai Stage III or IV (which are considered high-risk) than White patients (54% versus 46%).
- Death dates were available for 2,231 (18%) of patients.
- Among patients with death dates, the death rate eight years after the first visit was significantly higher for Black patients (61%) than for White patients (43%).
- Median overall survival was 7.5 years for Black patients and could not be estimated for White patients (meaning that it was longer than eight years).
- Annual income of <$30,000 was associated with a higher risk of a shorter time to death compared with income >$75,000.
Conclusions:
In US community oncology clinics, Black patients and patients with low incomes have poorer outcomes and survival compared with White patients and patients with higher incomes. This has been shown in other studies, and we continue to see these disparities persist in the era of targeted therapies.
Many possible contributors to these disparities include access to therapy, quality of care, underlying disease biology, or other factors. Whatever the reasons for these disparities, it is important to work together to ensure that all patients with CLL get the best possible care.
Links and Resources:
Here is the full ASH abstract: Racial and Socioeconomic Disparities Among Patients with Chronic Lymphocytic Leukemia (CLL) Treated in the US Community Oncology Setting
Take care of yourself first.
Ann Liu, PhD
