Examining racial differences in diffuse large B-cell lymphoma presentation and survival

• Type of Material: Article
• Authors: Christopher R Flowers, Emory University; Pareen J. Shenoy, Emory University; Uma Borate, University of Alabama Birmingham; Kevin Bumpers, Emory University; Tanyanika Douglas-Holland, Emory University; Nassoma King, Emory University; Otis W Brawley, Emory University; Joseph Lipscomb, Emory University; Mary Jo Lechowicz, Emory University; Rajni Sinha, Emory University; Rajinder S. Grover, Emory University; Leon Bernal-Mizrachi, Emory University; Jeanne Kowalski, Emory University; Will Donnellan, University of Alabama Birmingham; Angelina The, University of Alabama Birmingham; Vishnu Reddy, University of Alabama Birmingham; David L Jaye, Emory University; James Foran, University of Alabama Birmingham
• Language: English
• Date: 2013-02-01
• Publisher: Taylor & Francis: STM, Behavioural Science and Public Health Titles
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2012 Informa UK, Ltd.
• Final Published Version (URL): http://dx.doi.org/10.3109/10428194.2012.708751
• Title of Journal or Parent Work: Leukemia & Lymphoma
• ISSN: 1042-8194
• Volume: 54
• Issue: 2
• Start Page: 268
• End Page: 276
• Grant/Funding Information: Research reported in this publication was also supported by the National Cancer Institute of the National Institutes of Health under Dr. Flowers' Award Number R21CA158686.; This work was supported by Dr. Flowers' Georgia Cancer Coalition Distinguished Scientist Award and American Society of Hematology Amos Medical Faculty Development Award and Dr. Foran's University of Alabama at Birmingham Health Services Foundation Scholar of Excellence Award.
• Keywords: Hematology; Diffuse large B-cell lymphoma; CHOP regimen; ELDERLY-PATIENTS; Life Sciences & Biomedicine; disparities; CHOP; race; EPIDEMIOLOGY CONSORTIUM INTERLYMPH; Oncology; CANCER STATISTICS; FC-GAMMA-RIIIA; CLASSIFICATION; ANTI-CD20 MONOCLONAL-ANTIBODY; R-CHOP regimen; CHEMOTHERAPY PLUS RITUXIMAB; outcomes; Science & Technology; UNITED-STATES; NON-HODGKINS-LYMPHOMA
• Research Categories: Health Sciences, Oncology

Abstract

We performed a retrospective cohort analysis of 701 (533 white and 144 black) patients with diffuse large B-cell lymphoma (DLBCL) treated at two referral centers in southern United States between 1981 and 2010. Median age of diagnosis for blacks was 50 years vs. 57 years for whites (p < 0.001). A greater percentage of blacks presented with elevated lactate dehydrogenase levels, B-symptoms and performance status ≥ 2. More whites (8%) than blacks (3%) had a positive family history of lymphoma (p = 0.048). There were no racial differences in the use of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone; 52% black vs. 47% white, p = 0.73). While black race predicted worse survival among patients treated with CHOP (hazard ratio [HR] 1.8, p < 0.001), treatment with R-CHOP was associated with improved survival irrespective of race (HR 0.61, p = 0.01). Future studies should examine biological differences that may underlie the observed racial differences in presentation and outcome.