AML Disparities Across Racial Ancestry Groups: A Spotlight on the NPM1 Mutations

Racial and ethnic disparities in acute myeloid leukemia (AML) survival persist despite advances in treatment, with non-Hispanic black (NHB) patients and Hispanic patients often experiencing worse outcomes than Non-Hispanic White (NHW) patients due to a combination of clinical, socioeconomic, and biological factors. This review focuses on these disparities and emphasizes potential contributions of biology, as illustrated by the effects of the nucleophosmin 1 (NPM1) mutation. Mutation landscapes and chromosomal abnormalities strongly influence AML patient outcomes. While AML cases with NPM1 mutations are associated with favorable prognoses for NHW patients, NHB patients with NPM1-mutated AML have adverse outcomes. Thus, treatment algorithms and prognostic systems based on outcomes from a single racial ancestry group are inadequate. Beyond the more traditional socioeconomic determinants of health, addressing disparities in AML to achieve equity in care requires exploring biological factors linked to ancestry that shape treatment response.