(164) Influence of Patient Residence on Long-term Outcomes of Acute Lymphoblastic Leukemia Treatment at an Academic Medical Center

Poster Abstract:

Background: Acute lymphoblastic leukemia (ALL) remains one of the most common cancers in young persons, and while the mortality associated with ALL has been steadily decreasing over time, not all populations experience these benefits equitably. Overall survival (OS) of ALL decreases with increasing age, beginning with a stark survival cliff in the adolescent and young adult (AYA) populations. In addition to age and treatment regimen, there are several socioeconomic factors that may affect long-term outcomes for patients with ALL, including the medical center at which patients receive treatment. National guidelines specifically recommend that patients with ALL receive treatment at specialized centers. However, while some data demonstrate more favorable long-term ALL outcomes for patients treated at specialized cancer centers, other data have demonstrated that patients who travel longer distances for care may experience lower OS. The relationship between distance traveled to ALL treatment at a Comprehensive Cancer Center (CCC) and long-term outcomes, therefore, requires further elucidation.

Objectives: This study aims to examine the relationship between distance traveled to ALL treatment and long-term treatment outcomes for AYA patients at a single, academic CCC. The investigators will also explore the incidence of appointment cancellations among patients traveling farther for treatment and the significance of previously published risk factors for poorer long-term outcomes in patients with ALL.

Methods: This retrospective, single-center, cohort study will include patients aged 15-39 years old with previously untreated ALL who received at least 1 cycle of post-induction chemotherapy at Michigan Medicine between June 2014 and June 2023. Patients with ALL-like disease of high-grade-lymphoma with MYC and BCL2 and/or BCL6 rearrangements (AL-HGBL-MBR) will be excluded. Collected data will include patient demographics, baseline disease characteristics, treatment characteristics, and disease outcomes. The primary endpoint will be OS, and secondary endpoints will include event-free survival (EFS) and incidence of appointment cancellations or no-shows during courses 1-4 of therapy. Descriptive statistics will be used to describe baseline patient characteristics. Survival estimates will be calculated using the Kaplan-Meier method, and multivariate risk analysis will be assessed using a Cox Regression Analysis.

Results: Pending.

Conclusions: The results of this study will guide future risk assessment and resource allocation for patients with ALL.

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