Effect of race on the outcome of pediatric patients with Hodgkin's lymphoma.
OBJECTIVE
Some cooperative groups have found a survival disadvantage in black children with various childhood cancers. We examine the effects of race on clinical outcomes among children with Hodgkin's lymphoma (HL) treated with contemporary therapy at a tertiary care children's hospital.


METHODS
Retrospective analysis of 327 children and adolescents diagnosed with HL between 1990 and 2005. Patients were treated with risk-directed multimodal therapy regardless of race, ethnicity, or ability to pay. Event-free and overall survival rates were compared for black and white children. Clinical characteristics, socioeconomic factors, and biologic features were analyzed for prognosis of treatment failure.


RESULTS
The 262 white and 65 black patients did not differ significantly in presenting features, clinical characteristics, or enrollment in a clinical trial. More black patients (71% v 45%) resided in poor counties (P < .001). While black and white children were equally likely to have progressive disease or early relapse, black children were 3.7 times (95% CI, 1.7 to 8.0) more likely to relapse 12 months or more after diagnosis. The 5-year event-free survival was 71% +/- 6.1% (SE) for black and 84% +/- 2.4% for white children (P = .01). However, the 5-year survival rate did not differ between white and black children (94.4% v 94.7%). While black race and low hemoglobin concentration were independent predictors of treatment failure, only low hemoglobin concentration independently predicted poor survival.


CONCLUSIONS
Black children with Hodgkin's lymphoma have lower event-free survival than white children, but both populations have the same 5-year overall survival.
Metzger
Monika L
ML
Department of Oncology, St Jude Children's Research Hospital, Memphis, TN 38105-2794, USA. monika.metzger@stjude.org
Castellino
Sharon M
SM
Hudson
Melissa M
MM
Rai
Shesh N
SN
Kaste
Sue C
SC
Krasin
Matthew J
MJ
Kun
Larry E
LE
Pui
Ching-Hon
CH
Howard
Scott C
SC
D000293:Adolescent; D000328:Adult; D044383:Black People; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000208:ethnology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D015996:Survival Rate; D016896:Treatment Outcome; D044465:White People