Abstract B153: Age-related disparities in acute lymphoblastic leukemia: Hispanic patients present two decades earlier with distinct clinical features

Abstract Background: Acute lymphoblastic leukemia (ALL) demonstrates variable incidence and outcomes across ethnic populations. We investigated age at diagnosis and clinical characteristics between Hispanic and non-Hispanic adult ALL patients to identify potential health disparities impacting this vulnerable population. Methods: We conducted a retrospective cohort analysis of 28 adult ALL patients treated at our institution. Demographics, disease characteristics, and treatment outcomes were compared between Hispanic (n=15) and non-Hispanic (n=13) patients. Statistical analysis utilized Welch's unequal variances t-test for continuous variables and Fisher's exact test for categorical variables. Primary endpoint was age at diagnosis; secondary endpoints included Philladelphia chromosome positivity (Ph+), complete remission (CR) rates, and measurable residual disease (MRD) status. Results: Hispanic patients were diagnosed at significantly younger ages compared to non-Hispanic patients (mean 41.2 years [SD 13.4] vs 61.5 years [SD 11.0]; p=0.0003). This 20-year age difference persisted across disease subtypes. Notable clinical differences emerged: Ph+ ALL occurred less frequently in Hispanic patients (46.7% vs 69.2%), though this did not reach statistical significance. Hispanic and nonhispanic patients demonstrated comparable CR rates (80.0% vs 84.6%). However, MRD positivity (≥0.01%) was numerically higher among Hispanic patients (40.0% vs 30.8%), suggesting potential differences in treatment response. Conclusions: Hispanic adults developed ALL approximately two decades earlier than non-Hispanic patients in our cohort, representing a striking health disparity. The trend toward higher MRD positivity despite similar CR rates warrants further investigation. These findings highlight the critical need to identify ethnicity-specific risk factors and develop institutional, societal, and medical interventions to address disparities in adult ALL. Future studies should explore environmental and socioeconomic factors contributing to earlier ALL onset and diagnosis in Hispanic populations, with the ultimate goal of developing approaches that improve outcomes for this group. Citation Format: Matthew J. Slaught, George Grant, Elizabeth Brem. Age-related disparities in acute lymphoblastic leukemia: Hispanic patients present two decades earlier with distinct clinical features [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B153.