A Qualitative Study of the Initial Diagnosis and Treatment Experience of Black Patients with Newly Diagnosed Acute Myeloid Leukemia.

Purpose: Black patients with acute myeloid leukemia (AML) experience disparate outcomes, and factors such as structural racism and differential treatment access have been implicated. We sought to understand the experience of Black patients with newly diagnosed AML to gain insight into their unique experience. Methods: We interviewed Black patients ≥18 years of age with newly diagnosed AML (diagnosed from 7/1/2021 to 7/31/2022) over Zoom. Interviews were conducted by the same interviewer, with concordance in race between the interviewer and interviewees. A rapid qualitative content analysis was employed. Results: Ten patients were interviewed, with a median age of 63.5 years (range, 36-82 years). Six were male, married, and treated with a hypomethylating agent. Seven patients had secondary AML. Themes were broadly categorized under (1) the diagnosis and treatment experience, (2) challenges that arose, and (3) coping strategies. Unique findings included the experience of bias during the initial diagnosis period (but not during treatment decision-making discussions), and the overwhelming role of faith/religion/spirituality in coping. Other notable themes included trust, shock and urgent decision making, diverse support systems, physical limitations, the psychological impact, and financial constraints. Conclusions: Interviewed Black patients with newly diagnosed AML reported bias in the initial diagnosis period, possibly racially motivated, but did not feel this was at play in treatment discussions. The importance of faith/religion/spirituality in coping was also highlighted. Interventions focused on implicit bias training and supporting spiritual needs are critical to improve the experience of Black patients with AML and provide equitable care to all patients with AML.