Racial and Epidemiologic Patterns in Hospitalized CML Patients: A Multi-Year National Analysis
Introduction/Background/Significance: According to the American Cancer Society, nearly new cases of chronic myeloid leukemia (CML) are expected to be diagnosed in the United States in 2025, with just over 1,000 CML-related deaths projected. In this study, we aimed to examine comorbidity prevalence, in-hospital mortality rates, and healthcare burdens across different racial groups among patients admitted with a primary diagnosis of CML.
Materials and Methods/Case Presentation/Objective: We used the 2016, 2019, and 2022 National Inpatient Sample (NIS) databases to identify patients admitted with a primary diagnosis of chronic myeloid leukemia (CML), based on relevant ICD-10 codes. Patients were categorized by racial group to evaluate differences in epidemiologic trends, demographic characteristics, in-hospital mortality rates, and associated healthcare burdens.
Results/Description/Main Outcome Measures: A total of 9,235 patients hospitalized with a primary diagnosis of CML were identified from the 2016, 2019, and 2022 NIS databases. Of these, 48.02% were male, and the mean age was 53.41 years. Racial distribution included White (56.47%), Black (16.46%), Hispanic (15%), and Other (12.07%)—which included Asian, Pacific Islander, Native American, and other racial groups. The number of patients identified by year was 2,820 in 2016, 3,335 in 2019, and 3,080 in 2022. Congestive heart failure (CHF) was most prevalent among White patients (14.77%) and least common among Hispanic patients (7.22%) (p = 0.0009). Sepsis occurred more frequently in Black (6.91%) and Hispanic (6.14%) patients, while being least common in White patients (3.07%) (p = 0.0067). Chronic kidney disease (CKD) was most prevalent among White patients (14.86%) and the least common in the "Other" group (8.52%) (p = 0.0182). Bone marrow transplantation was most frequently performed in the "Other" group (3.59%) and least common among Hispanic patients (1.08%) (p = 0.0563). In 2016, the mean length of stay was significantly longer in Hispanic (5.66 days, p = 0.040) and Other (3.7 days, p = 0.026) patients compared to Whites. However, no statistically significant differences in length of stay or total hospital charges were observed across racial groups in 2019 or 2022. In-hospital mortality rates were 3.89%, 3.99%, and 5.22% in 2016, 2019, and 2022, respectively. There were no statistically significant differences in in-hospital mortality across racial groups in any of the years analyzed.
Conclusions: In this large, nationally representative sample of hospitalized CML patients, we observed notable racial disparities in comorbidity prevalence and healthcare utilization. White patients had higher rates of CHF and CKD, while sepsis was more common among Black and Hispanic patients. Although length of stay varied by race in 2016, no consistent differences in healthcare burden or mortality were observed in subsequent years. These findings underscore the importance of addressing racial differences in clinical presentation and care patterns to ensure more equitable outcomes for patients with CML.
