Introduction
Racial disparities in outcomes of children with acute lymphoblastic leukemia treated from late 1970’s until 2014 have been well documented with Black, Hispanic and Native American children having lower overall survival compared to White non-Hispanic patients. (1-4). Similarly, racial and ethnic differences in pediatric acute myeloid leukemia have also been observed with inferior survival observed among Black and Hispanic children compared to White non-Hispanic children.(5).Bhatia postulated that causes of these disparities in outcomes in children with cancer are multifactorial and include advanced stage at diagnosis, disease biology, poor treatment response, non adherence to therapy, health behaviors, lower socio-economic status, differences in enrollment in upfront clinical trials and differences in health insurance (6). Analysis of a large Center for International Blood and Marrow Transplant Registry (CIBMTR) cohort of pediatric and adult patients with HM, transplanted between 1995 and 2004 who received HCT from unrelated donors, indicated worse overall survival of African-American HCT recipients, compared to Whites and the difference was not fully explained by transplant-related factors or socio-economic status emphasizing again a complex, multifactorial etiology of those differences.(7)
Given the paucity of data on the impact of race on outcomes after HCT in children, we analyzed and present data from a contemporary cohort of children receiving first allogeneic HCT for hematologic malignancies in 5 Florida pediatric HCT centers between 2010 and 2019.