Lena E Winestone1,2, Richard Aplenc3,4. 1. Division of Allergy, Immunology, and BMT, Department of Pediatrics, University of California San Francisco (UCSF) Benioff Children's Hospital, 550 16th Street, San Francisco, CA, 94158, USA. Lena.Winestone@ucsf.edu. 2. Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, CA, USA. Lena.Winestone@ucsf.edu. 3. Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. 4. Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Abstract
PURPOSE OF REVIEW: The aim of this review is to summarize the current literature on pediatric leukemia disparities with attention to not only racial and ethnic disparities, but also socioeconomic disparities. We focus on disparities in survival as well as other health-related outcomes, including end-of-life care and late effects. RECENT FINDINGS: While progress has been made in decreasing some disparities, most notably in pediatric acute lymphoblastic leukemia, disparities along many axes persist. Proposed etiologies include differences in the genomic alterations of the leukemia itself to differences in access to care that operate through socioeconomic status, insurance, and geographic location. As approaches to therapy become increasingly technical and complex, particular attention to the equitable distribution of these personalized therapeutic interventions is essential. Moving beyond simple descriptive studies to focus on mechanisms of existing disparities will allow for design of interventions to reduce or eliminate disparities in pediatric leukemia.
PURPOSE OF REVIEW: The aim of this review is to summarize the current literature on pediatric leukemia disparities with attention to not only racial and ethnic disparities, but also socioeconomic disparities. We focus on disparities in survival as well as other health-related outcomes, including end-of-life care and late effects. RECENT FINDINGS: While progress has been made in decreasing some disparities, most notably in pediatric acute lymphoblastic leukemia, disparities along many axes persist. Proposed etiologies include differences in the genomic alterations of the leukemia itself to differences in access to care that operate through socioeconomic status, insurance, and geographic location. As approaches to therapy become increasingly technical and complex, particular attention to the equitable distribution of these personalized therapeutic interventions is essential. Moving beyond simple descriptive studies to focus on mechanisms of existing disparities will allow for design of interventions to reduce or eliminate disparities in pediatric leukemia.
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