Young African-American Lymphoma Patients Have Poorest Outcomes, Study Finds

Young African-American Lymphoma Patients Have Poorest Outcomes, Study Finds

African-American pediatric patients with Hodgkin lymphoma (HL) have poorer overall chances of survival compared to young white and Hispanic HL patients, according to a study conducted at the Sylvester Comprehensive Cancer Center at the University of Miami, Miller School of Medicine.

The study, “Racial and Ethnic Disparities in the Pediatric Hodgkin Lymphoma Population,” was published in the journal Pediatric Blood & Cancer.

“Little was known about the association between race, ethnicity and survival in the pediatric Hodgkin lymphoma population,” Joseph Panoff, MD, a radiation oncologist at Sylvester and lead author of the study, said in a news release. “Our study showed that African-American children and teenagers had worse overall survival than whites and Hispanics at 25 years after diagnosis. We also found that Hispanic males had inferior disease-specific survival compared to white males.”

In the U.S., lymphoma is the third most common malignancy in children and adolescents. National clinical outcomes for children with Hodgkin lymphoma (HL) are reasonably positive and have improved over the last decades. The five-year survival rate is now 95 percent, on average, for HL patients 19 years old or younger. But few studies have investigated how race or ethnicity might relate to survival in this group of patients.

Researchers included 7,800 HL patients, ages one month to 21 years (average: 17 years). All patients were listed in the Florida Cancer Data System (FCDS) (n= 1,778 patients) and the National Institutes of Health’s Surveillance, Epidemiology and End Results Program (SEER) (n=6,027).

In the FCDS cohort, blacks had worse overall survival than whites and Hispanics at 25 years (33% vs. 49.2% vs. 44.7%, respectively). In the SEER cohort, the results revealed that blacks also had inferior overall survival (blacks 74.2% vs. whites 82% vs. Hispanics 82%) and disease-specific survival (85.7% vs. 90.8% vs. 88.1%, respectively) at 25 years. Indeed, all patients in the FCDS cohort appeared to have worse overall survival than SEER cohort patients, indicating HL pediatric patients in Florida have worse outcomes when compared to the U.S. as a whole.

Hispanic males were also found to have inferior disease-specific survival compared to white males (84.8% vs. 90.6%). The results further showed that Hispanic race was a predictor for inferior disease-specific survival.

“Clearly, racial and ethnic disparities persist in the pediatric Hodgkin lymphoma population despite modern treatment, particularly in Florida,” Dr. Panoff said. “The underlying causes of these disparities are complex and need further explanation.”

Dr. Panoff added, “It is important to identify sociocultural factors and health behaviors that negatively affect overall survival in African-American patients and disease-free survival in Hispanic males. The fact that the entire Florida cohort seems to have worse overall survival than patients in the rest of the country is a new finding that requires further research.”

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