Evaluation of area deprivation index on clinical outcomes for acute myeloid leukemia patients at an urban academic medical center.

251 Background: Both biological and socioeconomic factors contribute to disparities in outcomes for patients with acute myeloid leukemia (AML). The Area Deprivation Index (ADI) is a validated composite measure of neighborhood-level disadvantage derived from 9-digit zip code–linked census block data. We hypothesized that higher ADI, reflecting greater socioeconomic deprivation, would be associated with worse clinical outcomes, including overall survival (OS), among AML patients treated at an academic urban center. Methods: We retrospectively reviewed 225 adult patients diagnosed with AML at the University of Maryland Medical Center in Baltimore, Maryland, between April 2013 and June 2020. Patients with acute promyelocytic leukemia or incomplete ADI data were excluded. ADI national percentiles were grouped into quartiles, with the fourth quartile (Q4) representing the highest level of socioeconomic deprivation. Clinical, demographic, cytogenetic, and treatment data were abstracted from the electronic medical record. OS was analyzed using Kaplan-Meier curves and Cox regression, using Q4 as the reference group. Results: Age at diagnosis, gender, insurance type, ECOG performance status, AML subtype (de novo vs. therapy-related), cytogenetic complexity, and intensity of induction therapy did not significantly differ across ADI quartiles. However, patients in the highest ADI quartile, the most socioeconomically deprived, had significantly shorter OS compared to those in quartiles 1–3 (log-rank p = 0.021). Conclusions: Neighborhood-level deprivation, particularly among patients in the highest ADI quartile, is significantly associated with inferior AML survival, independent of disease biology and treatment intensity. These findings highlight the prognostic importance of structural disadvantage and support the integration of ADI into risk models and equity-focused care strategies in hematologic malignancies.