Pediatric Leukemia Treatment Adherence Varies By Race
(HealthDay News) — Compliance with medication for acute lymphoblastic leukemia (ALL) in children varies according to race, according to research published online May 14 in Blood.
Smita Bhatia, MD, MPH, of City of Hope in Duarte, CA, and colleagues monitored adherence among 298 children (68 African-Americans, 71 Asians, and 159 non-Hispanic whites) receiving daily oral 6-mercaptopurine (6MP) as maintenance therapy for ALL.
The researchers found that, compared with non-Hispanic whites (95.8 ± 0.6%), adherence rates were significantly lower in Asians (86.1 ± 3.1%) and African-Americans (86.4 ± 2.4%). Race-specific factors that may explain poor adherence included low maternal education and single-parent/multiple-children households in African-Americans; low-income households in Asians; and households without mothers as full-time caregivers in both African-Americans and Asians. Non-adherence (defined as adherence rate <90%) occurred in 46% of African-Americans, 28% of Asians, and 14% of non-Hispanic whites. Non-adherence was associated with increased risk of relapse (hazard ratio, 3.1; P=0.04). About one-third (31%) of relapses were attributed to non-adherence.
"While outpatient oral 6MP treatment is relatively inexpensive, salvage treatment for relapsed ALL is expensive, associated with extensive morbidity, and largely unsuccessful, thus creating a critical need to develop measures to enhance adherence to oral 6MP," the authors write.