Examining racial differences in diffuse large B-cell lymphoma presentation and survival.
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.
Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA.
Christopher R
CR
Flowers
Pareen J
PJ
Shenoy
Uma
U
Borate
Kevin
K
Bumpers
Tanyanika
T
Douglas-Holland
Nassoma
N
King
Otis W
OW
Brawley
Joseph
J
Lipscomb
Mary Jo
MJ
Lechowicz
Rajni
R
Sinha
Rajinder S
RS
Grover
Leon
L
Bernal-Mizrachi
Jeanne
J
Kowalski
Will
W
Donnellan
Angelina
A
The
Vishnu
V
Reddy
David L
DL
Jaye
James
J
Foran
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D044383:Black People; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology* / Q000401:mortality*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D044465:White People; D055815:Young Adult