Abstract

Racial and ethnic inequities in survival persist for children with acute lymphoblastic leukemia (ALL). In the US, there are strong associations between SES, race/ethnicity, and place of residence. This is evidenced by ethnic enclaves: neighborhoods with high concentrations of ethnic residents, immigrants, and language isolation. The Latinx enclave index (LEI) can be used to investigate how residence in a Latinx enclave is associated with health outcomes. We studied the association between LEI score and minimal residual disease (MRD) in 142 pediatric ALL patients treated at Texas Children’s Hospital. LEI score was associated with end-induction MRD positivity (OR per unit increase 1.63, CI 1.12–2.46). There was also a significant trend toward increased odds of MRD positivity among children living in areas with the highest enclave index scores. MRD positivity at end of induction is associated with higher incidence of relapse and lower overall survival among children with ALL; future studies are needed to elucidate the exact causes of these findings and to improve ALL outcomes among children residing within Latinx enclaves.

Supplemental data for this article is available online at https://doi.org/10.1080/08880018.2022.2047850

摘要

对于患有急性淋巴细胞白血病（ALL）的儿童来说，种族和族裔的生存不平等仍然存在。在美国，社会经济地位、种族/民族和居住地之间存在着密切的联系。种族飞地就证明了这一点：种族居民、移民和语言隔离高度集中的社区。拉丁裔飞地指数 (LEI) 可用于调查居住在拉丁裔飞地与健康结果的关系。我们研究了德克萨斯儿童医院治疗的 142 名儿童 ALL 患者的 LEI 评分与微小残留病 (MRD) 之间的关联。LEI 评分与最终诱导 MRD 阳性相关（OR 每单位增加 1.63，CI 1.12-2.46）。居住在飞地指数得分最高地区的儿童中，MRD 阳性的几率也有显着增加的趋势。诱导结束时 MRD 阳性与 ALL 儿童较高的复发率和较低的总生存率相关；未来的研究需要阐明这些发现的确切原因，并改善居住在拉丁裔飞地的儿童的所有结果。

本文的补充数据可在线获取：https://doi.org/10.1080/08880018.2022.2047850