Acute lymphoblastic leukemia (ALL) is diagnosed in >3,000 children each year in the United States. It is the most common cancer in children and adolescents and the leading cause of death by disease in this population. Latino children and children from neighborhoods with low socioeconomic status are more likely to die from their disease. In a recent study of Texas children with ALL, we found that those in the poorest neighborhoods were 57% more likely to die from their disease than those in the wealthiest neighborhoods. However, the reasons for this are not clear, which makes it difficult for scientists, doctors, and policymakers to implement effective changes to improve outcomes for poor ...

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Acute lymphoblastic leukemia (ALL) is diagnosed in >3,000 children each year in the United States. It is the most common cancer in children and adolescents and the leading cause of death by disease in this population. Latino children and children from neighborhoods with low socioeconomic status are more likely to die from their disease. In a recent study of Texas children with ALL, we found that those in the poorest neighborhoods were 57% more likely to die from their disease than those in the wealthiest neighborhoods. However, the reasons for this are not clear, which makes it difficult for scientists, doctors, and policymakers to implement effective changes to improve outcomes for poor or Latino children. The first goal of this study is to understand how neighborhood-level characteristics like income, transportation, education, and language impact outcomes for children with ALL. In particular, we will evaluate how these relate to a child’s response to the first month of chemotherapy, and whether they can help us predict which children will relapse, because these are important predictors of survival. The second goal of this study is to understand whether children from neighborhoods with low average socioeconomic status or where many of the residents are Latino are more likely to have a pattern of altered metabolism that is associated with poor response to chemotherapy, as our data suggest. By achieving these goals, this study will help scientists and medical professionals understand the causes of important health disparities in childhood cancer, identify children who are at the greatest risk of dying from their disease, and transform the way cancer researchers think about social determinants of health like race, ethnicity, and socioeconomic status. We have chosen to study ALL because it is a leading cause of death by disease in children, but we believe that our approach and findings will also be relevant to other cancers in children and adults.

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