Methodological Considerations in the Study of Leukemia among Genetically and Culturally Heterogeneous Populations

摘要: Incidence of childhood acute lymphoblastic leukemia (ALL) differs by race and ethnicity, with lowest highest rates observed among African American Latino children, respectively, in the United States. Further, adverse treatment outcomes are higher both children. Reasons for these disparities unclear, but may be attributable to factors such as misclassification ethnicity cancer registry records differences early response treatment. information regarding genetic contribution is limited, particularly Americans Latinos. It has been suggested that ancestry serve an alternative measure risk admixed populations, date, no studies have reviewed validity this approach. A comparison self-reported participants California Childhood Leukemia Study (CCLS) reported Cancer Registry (CCR) found agreement was good Asian / Pacific Islander (API), Black, Hispanic/Latino, White CCLS (kappa > 0.7), comparatively poor Native multiracial <0.2). The main predictor ethnic identified a difference and/or between child's parents. Other contributing include father's education whether mother born outside Though rate ALL prior adjustment significantly Hispanics/Latinos compared non-Hispanic whites (risk ratio = 1.21 95%CI 1.09, 1.36), after even greater (RR 1.57, 1.40, 1.75) due prevailing directionality toward CCR. Baseline characteristics induction therapy Latino, White, non-White were assessed. Clinical at diagnosis did not differ exception level age diagnosis, which lower Whites (p-values 0.05 0.04, respectively), platelet (p-value 0.04). Overall treatment, proportion responding days 8 15, blast counts those day pre-B cell or any subgroups. For all groups combined, ETV6-RUNX1 translocation (difference 7.6%, 95% CI -2.6 to17.0%), high hyperdiploidy -15.0 %, -27.0 -3.6%), similar findings previous studies. Response substantially high-risk 25.0 -1.4 50.0 %). Finally, review 39 using markers through Pubmed database trends error estimation. Substantial confounding associations disease race, well associated including socioeconomic status, racial discrimination, place residence, observed. suggest utilize proxy continental confounded social environmental factors. As result, contributions incidence frequency health measures overestimated