Black Americans facing an aggressive blood cancer known as acute myeloid leukemia (AML) are being diagnosed younger and dying more often than white patients, even when they receive intensive chemotherapy in clinical trials designed to offer cutting-edge care. Compared with white patients, Black patients were on average more than five years younger at diagnosis and more than 30 percent more likely to die of their disease, according to a new analysis led by University of Maryland School of Medicine researchers. Over a 34-year period, Black patients were also more than 20 percent more likely to die of any cause.
Study first author Shella Saint Fleur-Lominy, MD, PhD, said the team’s findings “confirm those of previous, smaller studies: Black patients with AML develop the disease at a significantly younger age, on average, than white patients and, even when they’re treated in clinical trials, they have significantly worse outcomes than white patients.” The researchers analyzed 10 National Cancer Institute–supported clinical trials conducted between 1984 and 2019, including 3,469 white patients and 184 Black patients.
Genetic testing, often used to tailor AML treatment, did not fully explain the survival gap. The most common mutations appeared at similar rates in Black and white patients. Yet among patients whose cancer cells carried an NPM1 mutation—typically associated with more favorable outcomes—Black patients survived a median of 8.9 months, compared with 19.1 months for white patients.
Access to the most effective transplants also differed. While similar numbers received stem cell transplants overall, only 37 percent of Black patients received cells from a healthy, compatible donor, compared with nearly 49 percent of white patients. This donor transplant is described as offering patients with high-risk AML the best chance of a cure.
See: “Black patients diagnosed with aggressive leukemia experience worse outcomes, but differences not linked to key genetic changes” (17-DEC-2025)
