Grant Number:	5UH3CA260607-06 Interpret this number
Primary Investigator:	Gramatges, Maria
Organization:	Baylor College Of Medicine
Project Title:	Survivorship and Access to Care for Latinos to Understand and Address Health Outcome Differences (SALUD)
Fiscal Year:	2026

Pediatric cancer survivors (PCS) experience an excess risk of adverse outcomes related to their cancer diagnosis and the treatment they receive. The accumulation and severity of these acute and chronic health conditions broadly impact PCS functioning, quality of life, and health care resource utilization. Consequently, PCS are more likely to live in financial hardship, have lower educational attainment, be unemployed due to poor health, and be under- or uninsured compared with their age-based peers. Latino PCS are at particularly high risk for having a lower socioeconomic status (SES) compared with non-Latino PCS. These factors contribute to reduced access to routine medical care, and lower overall survival of Latino children diagnosed with cancer. Existing and well-established patient cohorts of PCS largely include long-term (at least 5 years) survivors and a relatively small proportion of Latino PCS, so that the outcome data that inform our understanding of risk for cancer treatment late effects, and therefore our clinical practice guidelines, are largely derived from the experiences of NHW PCS. The over-arching objective of this proposal is to identify and comprehensively assess adverse outcomes among Latino PCS that will inform clinical guidelines and lay the foundation for early, targeted interventions to mitigate such outcomes in this at-risk, growing population of PCS. Key to the success of our proposal is the prospective establishment of a PCS cohort in Texas that is linked with genomic and geographic data (UG3 planning phase), which will permit analyses of the interaction between genetics and SES on risk for adverse cancer treatment outcomes during the UH3 implementation phase. There is a significant unmet need to comprehensively characterize the socioeconomic, psychosocial, genomic, and metabolomic risk determinants of treatment-related toxicities and relapse in Latino PCS in the context of known clinical risk factors. In addition, among at-risk populations there is a critical need to identify facilitators and barriers to obtaining survivorship care. Therefore, utilizing existing and prospectively collected longitudinal data, we will: (1) Identify demographic, clinical, and genetic/molecular determinants of treatment-related toxicities and their association with chronic health conditions, patient-reported symptoms, and neurocognitive/ psychological and functional outcomes in PCS; (2) Identify demographic, clinical, and genetic/molecular determinants of the excess risk of cancer relapse/recurrence in PCS; and (3) Determine PCS understanding of risk for late effects and rationale for survivorship care, and identify perceived facilitators and barriers to obtaining survivorship care. This proposal synergizes multidisciplinary expertise and data collected from clinical and epidemiological resources to establish a prospective, comprehensive biobank and database of a large population of PCS from all backgrounds. Our aims represent the largest assessment to date of genetic and SES contributors to PCS outcomes, an effort that is imperative to inform risk assessments for adverse outcomes in this population, as well as potential barriers to obtaining optimal survivorship care.  




Supporting Survivor-Centered Care Through Digital Health Integration.
Authors: Marchak J.G. , Williamson-Lewis R. , O'Connor M. , Palgon M. , Kim Y.R. , Schuckenbrock M. , Edwards P. , Mendoza A. , Adams A. , Arriaga-Solis B. , et al. .
Source: Pediatric Blood & Cancer, 2026 Aug; 73(8), p. e70418.
EPub date: 2026-05-18 00:00:00.0.
PMID: 42145039
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Incidence and outcomes of treatment-associated hepatotoxicity during pediatric acute lymphoblastic leukemia induction therapy: a Reducing Ethnic Disparities in Acute Leukemia (REDIAL) Consortium report.
Authors: Chavana A.N. , Mason E.J. , Woodhouse J.P. , Taylor O.A. , Gramatges M.M. , Yi J.S. , Pruitt S. , Bernhardt M.B. , Ludwig K. , Klesse L. , et al. .
Source: Haematologica, 2026-07-01 00:00:00.0; 111(7), p. 2435-2439.
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Ethnic Differences in the Association Between SOD2 rs4880 and Hepatotoxicity in Pediatric Acute Lymphoblastic Leukemia: A Report From the REDIAL Consortium.
Authors: Mason E.J. , Woodhouse J.P. , Yi J.S. , Gramatges M.M. , Taylor O.A. , Morales V.A. , Dhamodharan S. , Roberts M. , Rabin K.R. , Lupo P.J. , et al. .
Source: Pediatric Blood & Cancer, 2026 Jul; 73(7), p. e70387.
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Lipidomic profiles associated with treatment related hepatotoxicity in children with acute lymphoblastic leukemia.
Authors: Mason E.J. , Schraw J.M. , Woodhouse J.P. , Gramatges M.M. , Williams K.J. , Chen B. , Harrell M.B. , Taylor O.A. , Scheurer M.E. , Lupo P.J. , et al. .
Source: Supportive Care In Cancer : Official Journal Of The Multinational Association Of Supportive Care In Cancer, 2026-02-17 00:00:00.0; 34(3), p. 209.
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An analysis of diagnostic metabolomic profiles associated with hepatotoxicity during childhood ALL induction therapy.
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Evaluation of methotrexate Pharmacogenomic variation to predict acute neurotoxicity in children with acute lymphoblastic leukemia.
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Source: Pharmacotherapy, 2024-12-29 00:00:00.0; , .
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Understanding and addressing race disparities in childhood cancer outcomes.
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Preferences for survivorship education and delivery among Latino and non-Latino childhood cancer survivors and caregivers.
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Ethnic-specific predictors of neurotoxicity among patients with pediatric acute lymphoblastic leukemia after high-dose methotrexate.
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