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

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.

Keywords::

• Diffuse large B-cell lymphoma
• race
• disparities
• outcomes
• CHOP regimen
• R-CHOP regimen

Acknowledgements

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. 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. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors appreciate the support of Alison Maggioncalda, Miray Seward, Gia Garrett, Neha Malik and Dionne Duc in the process of data collection.

Potential conflict of interest:

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