Residence in a Latinx enclave and end-induction minimal residual disease positivity among children with acute lymphoblastic leukemia

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

Keywords:

• ALL
• health inequities
• Latinx enclave
• MRD

Acknowledgements

We wish to acknowledge the patients who inspire our work and continue to motivate us daily.

Disclosure statement

The authors declare that there is no conflict of interest.

Additional information

Funding

This work was supported by a St. Baldrick’s Foundation Research Consortium Grant to PJL and KRR (522277), and by the Cancer Prevention Research Institute of Texas (RP180755 to PJL, RP160771 to MES, RP210075 to JMS). This research was also funded by United States National Institutes of Health (NIH) grant 1R01CA237540 (Principal Investigators: Sandi L. Pruitt and Salma Shariff-Marco), NIH grant 1P20CA262733-01 (Principal Investigators: Karen R. Rabin and Philip L. Lupo and Baylor College of Medicine (Pediatric Pilot Award to Philip J. Lupo).