Kudos to Nicole Caviness-Ashe, PhD student, and her sponsor Sophia Smith, associate professor, for the submission of her American Society of Hematology application entitled: “Examining Racial Health Disparities Among Survivors of Acute Myeloid Leukemia." This proposal requests funding for a two-year period with a start date of July 1, 2021.

Background: Acute myeloid leukemia (AML) is a life-threatening illness that requires aggressive treatment with significant toxicity. Survivors are typically hospitalized for weeks to undergo intense treatment and recovery of their blood counts. Physical symptoms include bleeding, bruising, fever, anemia, and fatigue. Survivors of AML also report high levels of uncertainty, anxiety, psychological distress, and social isolation. In addition, new evidence is emerging about racial health disparities among AL survivors. Despite having a lower incidence of illness, Black and Hispanic AML survivors have higher rates of morality compared to White survivors. However, there is limited research examining the impact of the cancer care experience and social determinants on health outcomes among Black AML survivors. More specifically, it is not known about the mediating role of the cancer care experience including racial discrimination in the relationship between a person’s background (demographic and clinical characteristics) and health-related outcomes (quality of life [QOL], symptom burden, and healthcare usage). Therefore, the purpose of this project is to examine how the cancer care experience impacts the relationship between patient characteristics including social determinants of health and quality of life (QOL).

Methods. Eligible participants will be identified using the Duke Cancer Institute (DCI) and University of North Carolina (UNC) Lineberger Tumor Registries. Eligibility criteria includes adults diagnosed with AML and assumed living. DCI and UNC Tumor Registry queries identified 482 and 313 people diagnosed with AML, respectively, including 52% male and 19% Black race. Living status is verified monthly via Social Security Death Index. AML survivors will be recruited through postal mailings and email; and, addresses for eligible participants will be obtained through the Tumor Registries and EPIC. Per the Tailored Design Method (TDM), the mailed survey package will include: a $5 bill; an introductory letter from the patient’s oncologist inviting participation; informed consent document; survey booklet; permission for future contact form; and, a return envelope with postage. Participants will be informed that completion of the survey will make them eligible for a drawing of one of ten $50 gift cards. To increase response rates and provide participants the ability to respond electronically if they choose, participants will also be recruited through email. Initial emails will include access to REDCap versions of the forms mentioned accessible through unique links. Follow up mailings, emails, and phone calls will take place according to a schedule informed by the TDM. Based on previous experience, there will be about 477 AML survivors (60%) who complete the survey study.