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Inequitable poverty exposures in a clinical trial cohort of children with acute lymphoblastic leukemia: an opportunity to address racial and ethnic disparities in pediatric oncology
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  • Kristine Karvonen,
  • Puja Umaretiya,
  • Victoria Koch,
  • Yael Flamand,
  • Rahela Aziz-Bose,
  • Lenka Ilcisin,
  • Ariana Valenzuela,
  • Peter Cole,
  • Lisa Gennarini,
  • Justine Kahn,
  • Kara Kelly,
  • Thai Hoa Tran,
  • Bruno Michon,
  • Jennifer Welch,
  • Joanne Wolfe,
  • Lewis Silverman,
  • Abby R. Rosenberg,
  • Kira Bona
Kristine Karvonen
University of Washington Department of Pediatrics

Corresponding Author:kristine.karvonen@gmail.com

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Puja Umaretiya
Dana-Farber Cancer Institute Department of Pediatric Oncology
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Victoria Koch
Dana-Farber Cancer Institute Department of Pediatric Oncology
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Yael Flamand
Dana-Farber Cancer Institute Department of Data Sciences
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Rahela Aziz-Bose
Dana-Farber Cancer Institute Department of Pediatric Oncology
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Lenka Ilcisin
Dana-Farber Cancer Institute Department of Pediatric Oncology
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Ariana Valenzuela
Dana-Farber Cancer Institute Department of Pediatric Oncology
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Peter Cole
Rutgers Cancer Institute of New Jersey
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Lisa Gennarini
Montefiore Medical Center
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Justine Kahn
Columbia University Department of Pediatrics
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Kara Kelly
Roswell Park Comprehensive Cancer Center
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Thai Hoa Tran
Universite de Montreal
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Bruno Michon
Centre Hospitalier de l'Universite de Montreal Centre de Recherche
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Jennifer Welch
Hasbro Children's Hospital
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Joanne Wolfe
Boston Children's Hospital Department of Pediatrics
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Lewis Silverman
Dana-Farber Cancer Institute Department of Pediatric Oncology
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Abby R. Rosenberg
Boston Children's Hospital Department of Pediatrics
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Kira Bona
Dana-Farber Cancer Institute Department of Pediatric Oncology
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Abstract

Black and Hispanic children with leukemia experience inferior survival compared to non-Hispanic White (NHW) children. Identifying modifiable social determinants of health can inform intervention targets to address inequities. We characterized the frequency of income poverty and household material hardship (HMH) by race/ethnicity in a clinical trial cohort with de novo acute lymphoblastic leukemia. Compared to NHW families, Black and Hispanic families reported more frequent HMH (19% vs. 47% vs. 68% respectively); low-income (27% vs. 52% vs. 74%), and combined low-income and HMH (12% vs. 37% vs. 52%) poverty exposures. Disparate poverty exposures are interventional targets to address racial/ethnic outcome inequities.