Study links poverty to increased ALL cancer relapse

Introduction

A new study conducted by the University of Alabama at Birmingham’s Marnix E. Heersink School of Medicine suggests a potential association between the economic status of a family and the likelihood of relapse in children diagnosed with acute lymphoblastic leukemia (ALL).

About Acute Lymphoblastic Leukemia (ALL)

Acute lymphoblastic leukemia is a type of blood cancer characterized by uncontrolled production of cancer cells in the bone marrow, leading to the prevention of normal blood cell formation. The treatment for ALL involves several years of chemotherapy, with cure rates exceeding 90 percent with modern treatments.

The Study

The study, published in the journal Blood by the American Society of Hematology, monitored over 600 participants who had been diagnosed with ALL. The average age of the participants was 6 years old, and they were followed for nearly eight years after completing their treatment.

Poverty Threshold

According to the Centers for Disease Control and Prevention, the weighted average poverty threshold for a four-person household in 2019 was $26,172. In this study, families with incomes below 120 percent of the federal threshold were considered to be living in extreme poverty. Overall, 12.3 percent of the study participants met the criteria for extreme poverty.

Findings

The researchers discovered that the chance of relapse in ALL patients three years after diagnosis was higher in households living in extreme poverty compared to those without extreme poverty. The likelihood of relapse was 14.3 percent for patients in extreme poverty, while it was 7.6 percent for those without extreme poverty.

Implications

The study’s findings raise questions about the potential biological effects of living in poverty and the structural barriers to adequate healthcare that caregivers may face, which could increase the risk of relapse in children with ALL.

Sustainable Development Goals (SDGs)

• SDG 1: No Poverty – The study highlights the impact of poverty on the health outcomes of children with ALL, emphasizing the need to address poverty as a key factor in achieving overall well-being.
• SDG 3: Good Health and Well-being – The research underscores the importance of providing adequate healthcare and support to children with ALL, particularly those living in extreme poverty, to improve their chances of recovery and reduce the risk of relapse.
• SDG 10: Reduced Inequalities – The study highlights the disparities in relapse rates between children living in extreme poverty and those without, emphasizing the need to address socioeconomic inequalities to ensure equal access to healthcare and better health outcomes.

Recommendations

Looking ahead, the lead researcher, Dr. Aman Wadhwa, suggests that pediatric oncologists screening for poverty among children with ALL can utilize available resources such as gas cards and food vouchers to assist families struggling with basic needs. Further research is needed to understand the causal mechanisms behind the increased risk of relapse in children living in poverty and to develop targeted interventions to improve cure rates for ALL.