ASH 2025: ECOG-ACRIN Study Links Black Race to Worse AML Survival After Intensive Chemotherapy

Researchers urge larger integrated datasets to clarify whether biology, care access, or both drive the disparity.

Overview

Across 10 ECOG-ACRIN trials from 1984 to 2019, Black patients had about a 21% higher risk of death and a 31% higher risk of recurrence or death after intensive therapy, independent of cytogenetics.
Black participants were diagnosed younger, with a median age of 47.9 years compared with 53.5 years for White participants.
Use of allogeneic donor transplant was lower in Black patients (37.1%) than in White patients (48.5%), despite similar complete remission and 30-day mortality rates.
European LeukemiaNet cytogenetic risk predicted overall survival in both groups but predicted disease-free survival only in White patients.
NPM1’s usual prognostic advantage was not observed in Black patients, and the decades-spanning dataset’s limited genomic coverage underscores the need for more comprehensive, modern analyses.