Journal of Clinical PathwaysThe Impact of Racial and Socioeconomic Disparities in Patients with Chronic Lymphocytic Leukemia

Unveiling Hidden Barriers: The Role of Race and Wealth in CLL Treatment Success

In a revealing study presented at the 2023 ASH Annual Meeting, Dr. Ira Zackon of New York Oncology Hematology discussed the impact of racial and socioeconomic factors on the outcomes of chronic lymphocytic leukemia (CLL) patients. This comprehensive analysis, based on extensive data from the US Oncology Network’s electronic health records, offers a crucial insight into how these determinants influence survival rates and disease progression among diverse patient groups.

Key Points

• Study Overview: Research focused on CLL, assessing differences in patient characteristics and outcomes based on race and socioeconomic factors from 2015 to mid-2023.
• Racial Composition: Among more than 12,000 CLL patients, 91% were White, 5% Black, and 4% Other.
• Age and Disease Stage: Black CLL patients were diagnosed 2 years earlier on average (68 years) compared to White patients (70 years), with more Black patients presenting at advanced stages (stage 3 or 4).
• Socioeconomic Factors: Lower education levels and household incomes (less than $30,000 annually) were more prevalent in the study population, though this data was available for only 25% of patients.
• Survival Rates: Black patients with CLL showed a 61% mortality rate compared to 43% in White patients, highlighting a significant racial disparity in survival.
• Income Influence: Adjusting for household income levels reduced the statistical significance of racial disparities in mortality, indicating a strong socioeconomic influence.
• Future Research Directions: Suggested focus on disease-specific factors (like p53 deletion/mutation status), treatment landscapes, and detailed social determinants of health for comprehensive understanding.
• Team-Based Care Importance: Emphasized the role of a diverse healthcare team in addressing identified issues and building trusting relationships with patients.

But it’s not just what we do, it’s how we do it. And so it really does take a team of providers, whether they be doctors, nurses, advanced practice providers, and your social workers and support team that you have to deliver care, and addressing issues that we can identify.
– Ira Zackon, MD, New York Oncology Hematology

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