ALL Outcomes SPORE

Latino children and adolescents experience both the highest incidence of leukemia and are among the lowest survival rates in the United States. The causes of these disparities are complex and likely involve interactions between genetic, biological, treatment-related and environmental factors. The Improving Outcome Disparities for Latino Children and Adolescents with ALL SPORE, or ALL Outcomes SPORE, seeks to identify and address these factors to improve outcomes and quality of life for all pediatric patients with ALL.

Supported by the National Cancer Institute (U54CA302464), this highly collaborative program is led by investigators from Baylor College of Medicine, Emory University, University of Alabama at Birmingham and University of California, San Francisco. The program focuses on translating discoveries from the laboratory, clinic and community into strategies that reduce disparities in treatment-related toxicities, improve survival and enhance long-term outcomes.

The program represents the first SPORE devoted to pediatric leukemia. In addition to four translational research projects, it includes specialized research cores, a Developmental Research Program and a Career Enhancement Program designed to foster innovation and train future leaders in pediatric cancer disparities research.

Building on the expertise of a multidisciplinary research team, the program aims to:

• Identify genetic and environmental factors associated with disparities in ALL outcomes
• Understand biological mechanisms that contribute to treatment-related toxicities
• Improve the use of pharmacogenomic information to guide treatment decisions
• Investigate social, environmental and biological contributors to patient-reported outcomes
• Develop prevention and intervention strategies that reduce disparities and improve survival among children and adolescents with ALL

The SPORE includes four integrated translational research projects designed to address key areas where disparities in outcomes have been observed among Latino children and adolescents with ALL.

Project 1: Understanding Population-Based Disparities in Treatment-Associated Hepatotoxicity During ALL Therapy

This project investigates factors associated with treatment-related liver toxicity, a significant complication of ALL therapy, particularly among Latino children. Researchers are studying demographic, biological and genetic contributors to hepatotoxicity and exploring approaches that may help prevent or reduce treatment-related complications.

Project 2: Understanding Population-Based Disparities in Methotrexate Neurotoxicity and Its Impact on Short- and Long-Term Adverse Outcomes Among Children and Adolescents with ALL

This project focuses on methotrexate-associated neurotoxicity, a potentially serious side effect of leukemia treatment. Investigators aim to identify genetic, biological and environmental factors that increase risk and develop strategies that improve treatment safety while maintaining effectiveness.

Project 3: Pharmacogenomic Advancements for Improved Treatment of Children and Adolescents with ALL

Researchers are evaluating the implementation of pharmacogenomic testing in diverse populations and how inherited genetic differences influence treatment response, toxicity and outcomes in ALL among different patient populations. Findings from this work may support more personalized approaches to leukemia treatment and help reduce disparities in outcomes.

Project 4: Patient-Reported Outcomes, Epigenetic Profiles, and Neighborhood Social Determinants of Health in Childhood ALL

This project explores how epigenetics, environmental exposures, social determinants of health and patient-reported outcomes interact to influence the experience and outcomes of children and adolescents with ALL. The goal is to identify factors to develop a psychosocial support intervention that can improve care and quality of life for at-risk children with ALL.

The ALL Outcomes SPORE is supported by four integrated cores:

• Administrative Core provides program leadership, coordination and oversight across all SPORE activities.
• Biospecimen Processing and Storage Core supports collection, processing and management of biospecimens needed to advance translational research projects.
• Biostatistics and Data Management Core provides statistical expertise, study design support and data analysis resources for all projects and programs.
• Community Outreach and Engagement Core strengthens partnerships with patients, families and communities while supporting research participation, education and dissemination of findings.

Together, these cores provide the guidance and infrastructure necessary to advance collaborative research focused on reducing disparities in pediatric ALL outcomes and accelerating the translation of discoveries into clinical practice.

Austin Brown, PhD
Associate Professor
Baylor College of Medicine

Monica Gramatges, MD, PhD
Professor of Pediatrics
University of Alabama at Birmingham

Philip Lupo, PhD, MPH
Professor of Pediatrics
Emory University

Karen Rabin, MD, PhD
Professor of Pediatrics
University of California, San Francisco

Grant support should be acknowledged for all projects, cores, and pilot projects. Each publication, press release, or other document about research supported by a National Institutes of Health award must include an acknowledgment of award support and a disclaimer such as:

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number U54CA302464. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.