Wright Center Internal Medicine Resident Continues Cancer Research Members News January 3, 2024 Wright Center Internal Medicine resident Dr. Lekha Yadukumar presented scholarly research in December on the demographics and disparities in Large Granular Lymphocyte (LGL) Leukemia at the American Society of Hematology’s 65th Annual Meeting and Exposition in San Diego, California. The third-year resident, who plans to pursue a career in hematology-oncology, worked with a University of Nebraska Medical Center hematology-oncology fellow to perform a retrospective cohort study of the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with the rare blood cancer from 2000-2020. They analyzed statistics on patient demographics, year of diagnosis, and timeline of treatment. Dr. Nirali Patel, core faculty with The Wright Center for Graduate Medical Education’s Internal Medicine Residency and associate program director of The Wright Center for Graduate Medical Education’s Geriatrics Fellowship,served as the study’s faculty mentor. The study examined statistics from 2,589 patients, with a median age of 67 years and 52.7% being men. In addition, 81.5% were Caucasians, 9.6% were African Americans, and 5.3% were Asians/Pacific Islanders, followed by 2% Hispanics and 1.5% American Indians. Nearly 92% of those included in the study were diagnosed after 2010, leading Yadukumar to note the increasing incidence over the last decade. “Younger age groups, females, and marital status have improved outcomes. Caucasians have better prognosis compared to other races,” said the Bangalore, India, native, adding that the findings spotlight the need for better representation of other races in clinical trials and to further investigate the tumor biology of the cancer. “The conference was a great opportunity, as I got to present my work to the leaders in this field,” Yadukumar said. “Next year, I am headed to the University of Iowa for my hematology-oncology fellowship, and the conference was a good platform for me.” The findings will also be published in “Blood,” a peer-reviewed medical journal published by the American Society of Hematology. Yadukumar’s first time exploring racial disparities in cancer research. She served as the lead researcher in a study that found Black men were diagnosed with breast cancer at a later age and had a higher mortality rate compared to white men. The findings were presented in a research poster at the May 2023 European Society for Medical Oncology Breast Cancer Annual Congress in Berlin, Germany. She worked on that study with several other doctors, including fellow Wright Center for Graduate Medical Education Internal Medicine Resident Dr. Amninder Singh. The study’s findings drew media attention, including an article in MD Edge, an online magazine dedicated to hematology and oncology news. Additionally, Yadukumar was inspired to study esophageal cancer hospitalizations in the transgender population after meeting a patient at The Wright Center for Community Health’s Ryan White HIV/AIDS Clinic. She utilized the national inpatient sample database from 2015-2020 for her study. Together with Wright Center Cardiovascular Disease Fellow Dr. Yaser Khalid and several other doctors and resident physicians from across the country, Yadukumar analyzed mortality, length of hospital stays, and total hospital costs for 212,425 patients, including 97,950 transgender patients. The research team presented their findings at the European Society for Medical Oncology’s World Congress on Gastrointestinal Cancer in Barcelona, Spain. “Our study showed transgender patients had a 5.1 times increased risk of death. They had increased total hospital costs and longer length of stays compared to the general population,” she said. “Our takeaway was that there is a significant difference in outcomes when we compare transgender people to the general population. While cis-gender differences in cancer prevalence and outcomes are well investigated, there is a need to study transgender populations to understand the existing disparities in their outcomes.” Through her research on this project, Yadukumar found the option to document a patient as transgender is not available in most cancer databases. “The health care system is truly biased against this population in our community, and there is a need to actively work on bridging this gap from a clinician perspective, as well as with research,” she added. For more information about The Wright Centers for Community Health and Graduate Medical Education, visit TheWrightCenter.org or call 570-230-0019.