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How Do Neighborhoods Impact Children's Chances of Surviving Leukemia?
Acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) are the most common pediatric cancers and among the leading causes of death in children.
To improve kids’ chances of survival, early diagnosis and prompt hospital treatment are required. ALL also requires numerous outpatient visits for consistent oral medication. The problem is getting access to such care is much harder for families in some neighborhoods and small towns, according to new research by UC San Francisco.
The study, published in Cancer, establishes new neighborhood characteristics that contribute to higher death rates in children with ALL. Lead author Lena Winestone, MD, MSHP, and her team point to these characteristics as opportunities for clinicians and policymakers to save lives.
What They Discovered
Children with ALL who live in mixed middle- and low-income neighborhoods, as well as those who live in Hispanic small towns, have a 30-40% higher risk of death compared to those in upper middle-income neighborhoods.
Compared to ALL, children with AML did not have a higher risk of death by neighborhood type. Why? Shorter AML hospital treatments and fewer outpatient visits likely reduce the challenges associated with following treatment plans for patients residing in underserved neighborhoods, according to researchers.
What Does it Mean?
The study uses a new classification of neighborhoods based on 39 unique characteristics, such as having an unhealthy food environment and lacking easy access to pharmacies and public transportation.
Based on these characteristics, the team identified tailored interventions to decrease death rates – such as boosting reliable access to care via pharmacies and transportation to appointments. These interventions are crucial for the prolonged outpatient care requiring consistent oral medication for kids with ALL.
Why it Matters
By ensuring every child can receive medication and make it to appointments, we can provide early, prompt, and consistent lifesaving treatment for all children regardless of ZIP code.
Authors: Lena E. Winestone, MD, MSHP, Juan Yang, MS, Tanushree Banerjee, PhD, Meera Sangaramoorthy, MS, Justine Kahn, MD, MS, Renata Abrahão, MD, MSc, PhD, Theresa H. Keegan, PhD, MS, Iona Cheng, PhD, MPH, Scarlett Lin Gomez, MPH, PhD, Salma Shariff-Marco, PhD, MPH.
Funding: This work is supported by the American Cancer Society, the Leukemia & Lymphoma Society, the California Department of Public Health; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries; the National Cancer Institute’s Surveillance, Epidemiology and End Results. For more information on funding, please see the paper’s Acknowledgements.
Disclosures: The authors have no conflicts of interest to disclose.
About UCSF Benioff Children’s Hospitals
UCSF Benioff Children’s Hospitals are among the nation’s leading pediatric specialty hospitals, according to U.S. News & World Report 2024-25 rankings. Their expertise covers virtually all pediatric conditions, including cancer, heart disease, neurological disorders, pulmonology, diabetes and endocrinology, as well as the care of critically ill newborns. The two campuses in San Francisco and Oakland are known for basic and clinical research, and for translating research into interventions for treating and preventing pediatric disease. They are part of UCSF Health, whose adult hospital ranks among the top medical centers nationwide and serves as the teaching hospital for the University of California, San Francisco, a national leader in biomedical research and graduate-level health/sciences education. Visit https://www.ucsfhealth.org.
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Cancer