title: Racial differences in presentation and management of follicular non-Hodgkin lymphoma in the United States: report from the National LymphoCare Study.
abstract: BACKGROUND
  Racial differences in follicular lymphoma (FL) in the United States have not been investigated.
  
  
  METHODS
  The National LymphoCare Study is a multicenter, longitudinal, observational cohort study collecting data on treatment patterns and outcomes for patients with newly diagnosed FL in the United States between 2004 and 2007 without any predefined, study-specific intervention. The authors investigated differences between white (W) patients, African American (AA) patients, and Hispanic (H) patients.
  
  
  RESULTS
  Among 2744 enrolled patients, there were 95 (3%) AA patients, 125 (5%) H patients, and 2476 (90%) W patients. Compared with W patients, more AA and H patients were diagnosed at age <45 years (P < .0001). H patients more commonly were diagnosed with grade 3 FL compared with AA and W patients (29%, 13%, and 18%, respectively; P = .019) and more commonly received rituximab plus chemotherapy as initial therapy compared with W patients (66% vs 50%; P = .036), while AA patients less commonly received anthracyclines (49% vs 64% in W patients; P = .027). H and AA patients who received rituximab plus chemotherapy were less likely than W patients to receive maintenance rituximab (27% vs 31% vs 40%, respectively; P = .031). At a median follow-up of 52 months, progression-free survival was similar between AA and W patients but was longer in H patients, and there was no difference in overall survival.
  
  
  CONCLUSIONS
  In the largest prospective cohort to date of AA and H patients with FL in the United States, AA and H patients were younger at presentation. Although racial differences in treatment patterns for FL were noted, additional follow-up is needed to determine the impact of these differences on survival.
authors.affiliation: Department of Medicine, Division of Hematology and Medical Oncology, Advocate Lutheran General Hospital, Park Ridge, Illinois, USA. cnabhan@oncmed.net
authors.forename: Chadi
authors.initials: C
authors.lastname: Nabhan
authors.forename: Michelle
authors.initials: M
authors.lastname: Byrtek
authors.forename: Michael D
authors.initials: MD
authors.lastname: Taylor
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Friedberg
authors.forename: James R
authors.initials: JR
authors.lastname: Cerhan
authors.forename: John D
authors.initials: JD
authors.lastname: Hainsworth
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Miller
authors.forename: Jamie
authors.initials: J
authors.lastname: Hirata
authors.forename: Brian K
authors.initials: BK
authors.lastname: Link
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Flowers
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D018943:Anthracyclines; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008224:Lymphoma, Follicular / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011446:Prospective Studies; D000069283:Rituximab; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D018943:Anthracyclines; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab