What question did this study set out to answer?

This research aims to investigate how neighborhood socioeconomic status and Hispanic enclave residence influence treatment outcomes in pediatric acute lymphoblastic leukemia.

April 5, 2026

Abstract 870: Neighborhood disparities and treatment outcomes in pediatric acute lymphoblastic leukemia (ALL): A report from the REDIAL Consortium.

Puntos clave

This research aims to investigate how neighborhood socioeconomic status and Hispanic enclave residence influence treatment outcomes in pediatric acute lymphoblastic leukemia.
Analyzed data from the REDIAL Consortium across six pediatric cancer centers in Texas.
Included children aged 0-24 diagnosed with acute lymphoblastic leukemia from 2005-2017.
Computed neighborhood socioeconomic status and Hispanic enclave indices from Census data.
Evaluated associations using logistic and Cox regression models adjusting for various clinical factors.
41% of patients lived in low socioeconomic status neighborhoods, while 42% resided in Hispanic enclaves.
No significant association found between enclave residence or low socioeconomic status and end-of-induction MRD positivity or survival outcomes.
Unadjusted results suggested a slight difference in 5-year event-free survival for low socioeconomic status areas, which disappeared after adjustments.

Resumen

Abstract Introduction- Acute lymphoblastic leukemia (ALL), the most common pediatric cancer, shows persistent outcomes disparities among socioeconomically disadvantaged and Hispanic children. Structural factors such as neighborhood socioeconomic status (nSES) and residence in Hispanic enclaves - culturally distinct neighborhoods with high concentrations of Hispanic residents, linguistically isolated households, and ethnic resources - may influence cancer outcomes, yet their impact on pediatric ALL remains unclear. We examined associations of nSES and Hispanic enclave residence with treatment outcomes in children with ALL. Methods- The REducing Disparities in Acute Leukemia (REDIAL) Consortium includes six pediatric cancer centers across Texas. We included children (0-24 years) diagnosed with ALL between 2005-2017 and treated at centers in Houston, Fort Worth, and McAllen. Census tract Hispanic enclave and nSES (Yost) indices were computed from U.S. Census and American Community Survey data. We defined Hispanic enclaves as tracts in the highest quintile (Q5) or Q4 adjacent to Q5 with 250 Hispanic residents, and low nSES as tracts in the lowest two quintiles of statewide distribution, using patient addresses at the time of diagnosis. Outcomes included end-of-induction (EOI) minimal residual disease (MRD) positivity (≥0.01%), relapse, event-free survival (EFS), and overall survival (OS). Associations were evaluated using logistic and Cox regression models adjusted for sex, age at diagnosis, race/ethnicity, NCI risk group, ALL immunophenotype, cytogenetic subtype, and treating institution. Results- Among 1,348 patients, 41% resided in low nSES tracts and 42% in Hispanic enclaves; 59% were Hispanic and 90% had B-ALL. Median follow-up was 5.6 years for EFS and 5.2 years for OS. In adjusted analyses, neither enclave residence (aOR= 1.22; 95% CI= 0.82, 1.80) nor low nSES (aOR= 1.06; 95% CI= 0.73, 1.55) were associated with EOI MRD positivity; similar null associations were observed for relapse (enclave: aOR= 0.88; 95% CI= 0.52, 1.49; low nSES: aOR= 1.04; 95% CI= 0.66, 1.64), EFS (enclave: aHR= 0.81; 95% CI= 0.52, 1.26; low nSES: aHR= 1.04; 95% CI= 0.71, 1.54), and OS (enclave: aHR= 1.07; 95% CI= 0.59, 1.94; low nSES: aHR= 0.89, 95% CI= 0.53, 1.51). Although unadjusted analyses indicated slightly poorer 5-year EFS for low nSES areas (81% vs. 85%, p=0.04), this difference attenuated after adjustment. Conclusions- In this large, multi-center, and diverse cohort of children with ALL, neighborhood socioeconomic disadvantage and residence in Hispanic enclaves were not independently associated with treatment outcomes after accounting for clinical and cytogenetic features. Future studies should examine other social determinants and the influence of neighborhood context on disease characteristics, survivorship, and late effects. Citation Format: Rutu Rathod, Amy E. Hughes, Pagna Sok, Karen Rabin, Sandi L. Pruitt, Philip J. Lupo, Michael E. Scheurer, Jeremy M. Schraw. Neighborhood disparities and treatment outcomes in pediatric acute lymphoblastic leukemia (ALL): A report from the REDIAL Consortium abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 870.

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