Abstract
This retrospective cohort study investigated racial disparities in time to treatment initiation and overall survival (OS) among 23,397 pediatric acute lymphoblastic leukemia (ALL) patients in the United States. Analyzing data from the National Cancer Database, the study revealed significant disparities among racial groups. Black patients had notably lower OS compared to White and Asian and Pacific Islander patients, with a higher hazard ratio (HR = 1.309). Spanish/Hispanic patients also exhibited lower OS and a higher HR compared to non-Spanish/Hispanic patients. These findings underscore the pressing need to address these disparities through comprehensive healthcare policy reforms, environmental regulations, and improved cultural competence within the healthcare system. Eliminating disparities in pediatric ALL incidence is essential to achieving health equity and ensuring the well-being of all children.