By Chris Hoenig
A new study out of the University of Texas MD Anderson Cancer Center shows that Black leukemia patients are more likely to die from the disease than patients of other ethnicities. But inconsistencies in this and other studies raise more questions than answers and have even the researchers themselves scratching their heads.
More than 1,600 patients with chronic lymphocytic leukemia (CLL) were tracked in the multiyear study. CLL is the second-most-common form of the disease, affecting about four out of every 100,000 Americans each year.
Of the 1,600 patients, Blacks were more than twice as likely as others to die of the disease (21 percent of Blacks died versus 9 percent of non-Blacks), and also stayed in remission for more than two years less than the other patients (36 months versus 61 months). Initial treatment results told a different tale, however, as 56 percent of Blacks had a “complete response” to treatment and went into remission, compared to 58 percent of the other patients.
“We noted that when we treated [African-Americans], they will respond in a similar way to the rest of the population, but their responses don’t last. They had worse outcomes,” study author Dr. Alessandra Ferrajoli said.
Discrepancies & Questions
Blacks accounted for only about 5 percent of the patients in the study84 out of 1,655. Despite the disparity in sample size of patients, no research exists to suggest that Blacks are any less likely to get CLL than other ethnicities.
The results are “not related to the treatment,” Ferrajoli said, because medical treatment was equal for all patients. Ferrajoli and study partners believe that the disparities in survival may relate to differences in the cancer cells. “The demonstration that these differences in survival persist even when similar therapies are administered for CLL is a novel finding, and it suggests that [African-American] patients may have different disease biology than [other] patients,” Emory University School of Medicine Associate Professor Dr. Christopher Flowers said.
If the cancers themselves are different, they should be treated appropriately, right “For other diseases, there may be differences in treatment … but not for ours at this point,” Ferrajoli said, as researchers continue to ponder the racial disparity in cancer outcomes. “We don’t have an answer.”
Getting Accurate Information Through Nonbiased Clinical Trials
Pharmaceutical companies, such as Eli Lilly and Company (No. 35 in the DiversityInc Top 50), have strategies in place for clinical trials to ensure that they are getting the most accurate information on medication efficacy in underserved populations.
“Because medicines don’t work the same for everyone, we need to understand how medicines work and the safety profile in the patients likely to take them. And because culture can strongly influence how patients define health perception, lifestyle choices and healthcare-seeking behaviors, we need to understand relevant cultural differences that impact patient outcomes,” says Dr. Coleman Obasaju, Senior Medical Director, Lilly Oncology and Global Leader, Diversity in Clinical Research.
Eli Lilly will present on Diversity in Clinical Trials at DiversityInc’s Sept. 24 event, Culturally Competent Healthcare: How Diversity Creates Better Patient Outcomes.
Eliminating Racial Disparities in Healthcare
“It’s a complex problem, but there are clearly avoidable components of this that we can address and resolvethe issues related to healthcare quality,” Dr. Marcus Plescia, Director of the Division of Cancer Prevention and Control at the CDC, told The New York Times last year. “It’s time to step forward and say that this disparity is unacceptable.”
University Hospitals CEO Thomas Zenty recently discussed the impact of diversity management and new healthcare reform laws with DiversityInc CEO Luke Visconti, noting the growing need for hospitals and other providers to take a proactive approach to eliminating racial gaps in healthcare coverage. University Hospitals is No. 1 in the DiversityInc Top 10 Hospital Systems.
“Many studies have shown that there is a direct correlation between people of diverse backgrounds being willing to seek care and knowing that people who look like them will actually be providing that care. So the intersection between diversity and disparities is rather significant,” explains Zenty in the video below. “We want to make certain that we’re doing everything that we can to make sure that people of color will be able to work in our organization, hold positions of leadershipcaregivers, clinicians and support staff.”
Read this Q&A with University Hospitals CEO Thomas Zenty for more.