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Improving Outcome Disparities for Latino Children and Adolescents with Acute Lymphoblastic Leukemia

改善患有急性淋巴细胞白血病的拉丁裔儿童和青少年的结果差异

基本信息

批准号：
10289493
负责人：
Philip Lupo
金额：
$ 112.29万
依托单位：
BAYLOR COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-20 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10289493
关键词：
Accounting Acute Acute Lymphocytic Leukemia Acute leukemia Address Adolescent Behavioral Biological Biological Factors Biology Biometry Blood Bone Marrow Cancer Center Cerebrospinal Fluid Child Childhood Acute Lymphocytic Leukemia Childhood Leukemia Clinical Clinical Data Clinical Treatment Data Set Development Ethnic Origin Etiology Fostering Foundations Future Genetic Goals Health Hepatotoxicity Hispanics Incidence Infrastructure Inherited Intervention Investments Latino Malignant Childhood Neoplasm Methotrexate Modeling Morbidity - disease rate Neoadjuvant Therapy Newly Diagnosed Obesity Outcome Patients Pharmacogenomics Pharmacometabolomics Pilot Projects Prevention strategy Process Prospective cohort Race Recurrence Relapse Research Research Project Grants Risk Risk Factors Role Sampling Socioeconomic Status Specialized Program of Research Excellence Specimen Handling Statistical Data Interpretation Survival Rate Testing Toxic effect Translating Treatment outcome Treatment-related toxicity Tumor Biology Variant Vulnerable Populations Work acute toxicity adverse outcome base biobank data management effective intervention ethnic difference ethnic disparity ethnic diversity health care availability improved improved outcome innovation leukemia metabolomics modifiable risk mortality neurotoxicity novel novel imaging technique programs racial and ethnic racial and ethnic disparities risk prediction model social social health determinants treatment strategy tumor white matter

项目摘要

Summary Acute lymphoblastic leukemia (ALL) is the most common cancer in children and, although cure rates have improved over the past 50 years, ethnic disparities persist. In particular, Latinos have the highest incidence and among the lowest survival rates for leukemia in the U.S. The underlying causes of this disparity are multi-factorial, including differences in tumor and host biology, as well as social/behavioral factors such as limited healthcare access. Host pharmacogenomics and other biological factors resulting in increased treatment-related toxicities are a key and under-studied cause of ethnic disparities in outcomes. Adverse outcomes result both from direct treatment-associated morbidity and mortality, and from compromised ability to deliver sufficiently intensive anti- leukemic therapy. The overall goals of this P20 program are to reduce outcome disparities among Latino children and adolescents by identifying host biological factors that result in increased toxicities, and to lay the groundwork for establishment of the first Specialized Programs of Research Excellence (SPORE) devoted to pediatric leukemia. The two primary Research Projects will identify factors associated with risk for two key treatment-related toxicities, hepatotoxicity and neurotoxicity, which adversely impact treatment outcomes and occur disproportionately in Latinos. The eventual SPORE will expand upon this work by (1) pursuing prevention and treatment strategies and (2) investigating ethnic disparities in other clinically impactful treatment-related toxicities. The Program will be administered through the Administrative Core (Core A). Biospecimens will be processed by Core B, and statistical analysis will be provided by Core C. A Developmental Research Program will foster development of innovative pilot projects that aim to understand and/or reduce ethnicity-based disparities in ALL outcomes. We will leverage the Reducing Ethnic Disparities in Acute Leukemia (REDIAL) Consortium, comprising 6 cancer centers in the southwestern U.S., which will provide clinical data from 3,000 and clinical data, bone marrow, blood and cerebrospinal fluid samples from nearly 2,000 children and adolescents with newly diagnosed ALL for the following two novel and integrated Projects. Our synergistically integrated team will define key biological factors associated with hepatotoxicity and neurotoxicity, important contributors to ethnic outcome disparities. More broadly, this Program will further strengthen and expand the REDIAL Consortium, with its invaluable ethnically diverse dataset and biorepository, and model its use for development of risk prediction models that identify Latino patients at risk for toxicities and illuminate the underlying biology mechanisms. This work will form the foundation for a future SPORE that will investigate additional toxicities of ALL therapy, and translate these findings into development of effective intervention strategies. This efficient monetary investment will result in significant reductions in outcome disparities in Latino children and adolescents with ALL.

总结