The study, published in the journal Cancer, found that non-biological factors are as important as biological variables in shaping outcomes in young patients with leukemia.
A group of physician researchers at the University of Alabama at Birmingham studied the impact of non-biological factors on the survival of young patients with acute myeloid leukemia (AML). The study, which included 5541 patients younger than 65 years of age, discovered that insurance status, marital status, and county-level income were independent factors that influenced patient survival.
“We have made tremendous progress in understanding the biology of AML. But we need to pay the same attention to resources available to our patients as this greatly impacts their chances to survive their leukemia,” said Luciano Jose Costa, MD, PhD, associate professor in the UAB Division of Hematology and Oncology, and senior author on the study. “By pointing to the factors that likely have nothing to do with biology as having a strong effect on survival of younger AML patients, this study reveals other opportunities to improve outcomes. The focus needs to change somewhat from the cancer to the cancer patient.”
The study cohort included patients with AML aged 19 to 64 years, diagnosed between 2007 and 2011, and included in the SEER 18 registry. Along with biological factors (disease subtype, sex, age, and race/ethnicity), the authors evaluated whether non-biological factors such as marital status, insurance status, county-level income, and education could significantly influence patient survival.
While the median overall survival was 16 months in the entire population, Medicaid enrollees, uninsured, single, divorced, and residents of low-income counties had an increased risk of death, the authors found. The researchers conclude that interventions that would mitigate the impact of social factors on survival among patients with AML are needed.
“Factors that have nothing to do with quality of care need to be accounted for when comparing predicted with actual outcomes,” said Uma Borate, MD, a co-author on the study.
The study has been published in the journal Cancer.