2023 Department of Pediatrics Academic Annual Report

Hign Impact Research

Study Assesses the Poverty and Relapse Risk in Children with Acute Lymphoblastic Leukemia by Emily Franklin

The study, led by Aman Wadhwa, M.D., assistant professor in the Division of Pediatric Hematology and Oncology, assessed individual-level poverty using self-reported annual household income and US Census Bureau yearly poverty data. This study was a secondary

analysis of Children’s Oncology Group study AALL03N1, whose primary aim was to examine adherence to oral 6-mercaptopurine during maintenance in children with ALL. The study chair was Smita Bhatia, M.D., MPH, director of the Institute for Cancer Outcomes and Survivorship and professor in the Division of Pediatric Hematology and Oncology. Among the 592 patients in this analysis, researchers found that 12.3% of the patients were living in extreme poverty. The cumulative incidence of ALL recurrence at three years following study enrollment was significantly greater among those living in extreme poverty (14.3%) than among those not living in extreme poverty (7.6%) during a median follow-up of 7.9 years. Based on the study’s findings, researchers discovered that children with ALL who lived in extreme poverty had a nearly two-fold increased risk of experiencing a relapse. Additionally, the study showed that children with ALL living in extreme poverty were significantly less likely to achieve the critical level of adherence to 6-mercaptopurine required to reduce the risk of relapse. However, this lower level of adherence did not completely explain the higher risk of relapse in children living in extreme poverty.

Aman Wadhwa, M.D.

Smita Bhatia, M.D., MPH

2023 Academic Annual Report

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