Conference Abstracts - 2025 Summit on Hematologic Cancers
Vol. 5, Issue Supplement 1, 2025 · S1-2
Racial Differences in Acute Myeloid Leukemia Survival Among Asian Indian and Pakistani Americans Versus Non-Hispanic Whites: A SEER-Based Analysis
Anish Shah, MD,Rosy Shah, MBBS,Rahul Thakur, MD,Dipesh Mandal, MD
Submission received: 2025-07-15 / Accepted: 2025-07-28 / Published: 2025-09-16
Abstract
Background
Acute myeloid leukemia (AML) is a biologically aggressive hematologic malignancy with early mortality risk. While racial disparities in AML outcomes are well-characterized for Black and Hispanic populations, outcomes among Asian Indian and Pakistani Americans (AIPA)—a rapidly growing subgroup—remain poorly defined. This study compares survival outcomes between AIPA and Non-Hispanic White (NHW) AML patients using national registry data.
Methods
Adults (≥18 years) diagnosed with AML from 2000–2022 were identified using the SEER database. Patients were classified as AIPA or NHW using race and origin recodes. Kaplan-Meier survival analysis with log-rank testing compared unadjusted survival. Cox proportional hazards models evaluated associations with overall survival (OS), adjusting for age, sex, year of diagnosis, and chemotherapy receipt.
Results
A total of 51,413 AML patients were analyzed, including 380 AIPA and 51,033 NHW individuals. AIPA patients were younger at diagnosis and had lower chemotherapy utilization. Unadjusted analysis showed significantly improved survival among AIPA patients (log-rank p<0.001). In univariate Cox regression, AIPA ethnicity was associated with improved OS (HR 0.70; 95% CI: 0.63–0.78; p<0.001). After multivariable adjustment, AIPA patients retained a borderline survival benefit (HR 0.91; 95% CI: 0.83–1.01; p=0.08). Chemotherapy was strongly associated with improved OS (HR 0.67; p<0.001), while older age was associated with worse OS (HR 1.04 per year; p<0.001). Female sex conferred a modest survival benefit (HR 0.94; p<0.001).
Conclusion
AIPA patients with AML demonstrated improved unadjusted survival compared to NHW patients. Although this difference attenuated after adjusting for clinical variables, the trend remained. These findings highlight potential biological or sociocultural factors influencing AML outcomes and provide a benchmark for comparison with South Asian populations globally.