Neighborhood Factors, Acute Kidney Injury and Disparities in Pediatric Acute Myeloid Leukemia
Co-Investigators: Dr. Yimei Li, Dr. Tamara Miller & Dr. Marla Daves
Background: Pediatric acute myeloid leukemia (AML) is the second most common pediatric leukemia and requires intensive treatment for a cure. These treatments have been less effective for racial and ethnic minority patients. Unfortunately, the reasons for this disparity in treatment outcomes are not known.
Project Goal: We propose to implement a new and potentially powerful way to build a cohort of patients with AML by automatically extracting data from the electronic medical records of four leading pediatric hospitals in the United States. Such a data extraction would enable a wide range of clinical epidemiology studies that may shed new light on the racial and ethnic disparities in pediatric AML. For this application, we plan to use this cohort-building method to study kidney damage during treatment for AML. We have chosen to study kidney damage based on prior data showing racial differences in the risk of kidney damage and the limited data on the causes of this disparity. Thus, this study will serve as a test case for the application of this new, cohort-building approach. In addition, if successful, this study may provide information about the risks of kidney damage during AML therapy that may identify changes that could decrease the risk of kidney damage. Additionally, this study may help identify modifiable causes for the disparities in kidney damage and AML outcomes in children.
Project Update 2021: We have developed, implemented, and made available a software package for extracting data from the electronic medical record at hospitals using EPIC as their medical record system. We have used this software to collect approximately 1,700 patients of whom approximately 280 have acute myeloid leukemia. Within this patient group, we are identifying and evaluating risk factors for kidney dysfunction that occurs before and during treatment. We hope that these data will help improve the care of children with acute myeloid leukemia. This data resource is being actively used by multiple investigators to address other clinically important questions in pediatric oncology with a particular focus on treatment disparities.
