ECOG-ACRIN Review Finds Black AML Patients Have Worse Survival Independent of Cytogenetics

Overview

• Across 10 NCI-supported ECOG-ACRIN trials (1984–2019; n=3,809), Black race independently predicted shorter overall and disease-free survival after intensive chemotherapy.
• Hazard ratios showed higher risk for Black patients vs white patients for overall survival (HR 1.21; 95% CI, 1.01–1.45) and disease-free survival (HR 1.31; 95% CI, 1.05–1.64).
• Black patients were younger at diagnosis (median 47.9 years vs 53.5 years) despite similar distributions of ELN cytogenetic risk and key mutation prevalence.
• NPM1 mutations did not confer the usual favorable outcomes for Black patients, with median overall survival 8.9 months vs 19.1 months for white patients with NPM1-mutated AML.
• Allogeneic transplant use was lower among Black patients who underwent transplant (37.1% vs 48.5%), and ELN risk predicted disease-free survival in white patients but not in Black patients.