Socioeconomic Factors Influencing Treatment and Outcomes in Acute Myeloid Leukemia.

Abstract: Evaluation and reduction of socioeconomic inequalities in cancer survival are a public health priority worldwide. In developing countries such as India, the high-economic burden of acute myeloid leukemia (AML) remains understudied despite its severe impact on outcomes. This study investigated the impact of socioeconomic factors on mortality and survival in AML. Conducted from January 2019 to February 2022 at a tertiary care center in India, it included 41 newly diagnosed AML patients. Socioeconomic determinants such as education, insurance status, social support, and socioeconomic status (SES) (using the Modified Kuppuswamy Scale, 2021) were assessed. Using adjusted multivariable Cox proportional hazards ratio (HR), the study found that lower SES was associated with an increased mortality risk compared to the upper socioeconomic class (lower-middle class HR = 19.9 [P = 0.027], upper-lower class HR = 400 [P = 0.004], and lower class HR = 1221 [P = 0.002]). The overall survival difference between SES classes was not statistically significant. This evidence emphasizes the need for equitable access to AML treatment in developing countries.