Comparison of Five-Year Survival Rate Between Black and White Children With Acute Lymphoblastic Leukemia

Abstract

Introduction Despite improvements in the prognosis of acute lymphoblastic leukemia (ALL), it is still the most common childhood cancer. The goal of this study was to investigate if there was a significant difference in the five-year survival between Black and White children with ALL, specifically up to the year 2016 which has not been researched. Methods A retrospective cohort study of Black and White children diagnosed with ALL between 1975 and 2016 was carried out using the Surveillance, Epidemiology, and End Results (SEER) Program database. Children aged 0-19 were separated into Black or White, and then survival analysis was used to compare five-year survival. A multivariate cox regression analysis was carried out to determine the association between race and five-year survival with ALL. Results Our sample included 17,663 cases consisting of 16,238 White children and 1,425 Black children. White children had a significantly increased five-year mortality survival when compared to Black children. Upon using multivariate cox regression analysis, both unadjusted and adjusted models showed a significantly higher risk of death in Black children when compared to White children. Conclusions Our study found that there is a significant difference in the five-year survival between Black and White children diagnosed with ALL. The difference in survival persists even when controlling for sex, age at diagnosis, year of diagnosis, and histology. Future studies should be carried out to control for more confounders that the SEER database is unable to control for.