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Study Shows Inferior Outcomes for African American Pediatric Lymphoma Patients

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Key Points

  • Hispanic males also have inferior disease-specific survival compared to white males.
  • In the FCDS cohort, which was significantly smaller than the SEER cohort, African Americans had a 33% overall survival rate at 25 years, compared to 49.2% for whites and 44.7% for Hispanics.

Researchers from Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine have published a study showing that African American pediatric patients with Hodgkin lymphoma have inferior overall survival compared with their white and Hispanic peers. The study, published by Grubb et al in Pediatric Blood & Cancer, is the largest investigation yet on racial and ethnic disparity in the pediatric Hodgkin lymphoma population.

“Little was known about the association between race, ethnicity, and survival in the pediatric Hodgkin lymphoma population,” said Joseph Panoff, MD, a radiation oncologist at Sylvester. “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 United States, lymphoma is the third most common malignancy in children and adolescents. Hodgkin lymphoma comprises roughly half of all lymphoma diagnoses. National outcomes for children with Hodgkin lymphoma are relatively favorable and have improved over the last few decades, with current 5-year survival rates averaging 95% for patients 0 to 19 years of age.

Key Findings

Dr. Panoff and his colleagues analyzed Florida-specific data as well as national data from more than 7,800 patients, 0.1 to 21 years of age (average: 17 years), who were listed in the Florida Cancer Data System (FCDS) and the National Institutes of Health's Surveillance, Epidemiology, and End Results Program (SEER). All Hispanics, non-Hispanic whites, and non-Hispanic African Americans were included in the analysis.

In the FCDS cohort, which was significantly smaller than the SEER cohort (1,778 vs 6,027), African Americans had a 33% overall survival rate at 25 years, compared to 49.2% for whites and 44.7% for Hispanics. Overall, patients in the FCDS cohort seemed to have worse overall survival than patients in the SEER cohort, indicating patients treated in Florida have worse outcomes when compared to the rest of the nation.

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

As a next step, Dr. Panoff suggested identifying flaws within the diagnostic and treatment process with regard to African American and Hispanic patients. He 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.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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