Compared to white patients, Black individuals diagnosed with acute myeloid leukemia (AML) are more likely to face the disease at a younger age and have poorer outcomes, according to a new analysis spanning 34 years. The study was conducted by the ECOG-ACRIN Cancer Research Group and supported by the National Cancer Institute (NCI), part of the U.S. National Institutes of Health.
Researchers reviewed records from 10 clinical trials run between 1984 and 2019. Data were collected for 3,469 white patients, 184 Black patients, and 156 patients from other racial and ethnic backgrounds. Black patients were found to be diagnosed with AML at a median age of 47.9 years, which is over five years younger than the median age of diagnosis for white patients (53.5 years).
The analysis also showed that Black patients had a 31.3% higher risk of dying from AML and a 21.2% higher risk of dying from any cause compared to their white counterparts.
One notable finding was related to mutations in the NPM1 gene, which is typically associated with better treatment outcomes in AML. However, "Although the NPM1 mutation is typically associated with more favorable outcomes of AML treatment, we did not see those more favorable outcomes in Black patients," said Dr. Shella Saint Fleur-Lominy of the University of Maryland School of Medicine.
Black and white patients overall received similar rates of blood-forming stem cell transplants. Yet fewer Black patients (37.1%) received stem cells from healthy, compatible donors compared to white patients (48.5%). According to Dr. Saint Fleur-Lominy, this type of transplant offers those with high-risk AML the best chance for a cure.
Clinical trial participation among Black cancer patients has increased in recent years but remains low relative to population proportions, despite efforts aimed at improving access across all backgrounds.
Dr. Saint Fleur-Lominy noted that some limitations exist in the study: "The study includes data for patients treated across four decades...the advanced technology now available to perform such testing did not exist when clinical trials of AML treatment were conducted in earlier decades." She indicated plans for future research: combining these findings with additional data sets may help confirm whether genetic mutations impact survival differently between Black and white patients.
Dr. Saint Fleur-Lominy will present these results on December 6, 2025, at the Orange County Convention Center.
