Racial differences in the presentation and outcomes of diffuse large B-cell lymphoma in the United States.
BACKGROUND
Diffuse large B-cell lymphoma (DLBCL) is often cured with standard chemoimmunotherapy, but there is great heterogeneity in presentation and outcomes.


METHODS
By using Surveillance, Epidemiology, and End Results (SEER) data from 13 registries across the United States, the authors examined differences in incidence and survival for DLBCL by race. International Classification of Diseases for Oncology, third edition histology codes 9678, 9679, 9680, and 9684 were used to identify cases.


RESULTS
From 1992 to 2007, 38,522 cases of DLBCL were recorded in SEER. Sixty-five percent of black patients compared with 37% of white patients presented at age ≤ 60 years, 52% of blacks compared with 44% of whites presented with stage III/IV disease, and 31% of black versus 24% of white patients presented with B symptoms (all P < .001). Although survival improved by era of diagnosis for all races (log rank P < .001), 2-year relative survival rates were better for women than men (61% vs 58%, P < .001) and white than black patients (60% vs 50%, P < .001). Black race, male sex, age at diagnosis >60, advanced stage, and B symptoms at diagnosis were predictors of worse survival (P < .001).


CONCLUSIONS
Black patients with DLBCL in the United States present at younger age, more advanced stage, and have inferior survival. Epidemiological studies that examine the biological variants of DLBCL in concert with race are needed to elucidate the etiology of these disparities.
Winship Cancer Institute-Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia.
Pareen J
PJ
Shenoy
Neha
N
Malik
Ajay
A
Nooka
Rajni
R
Sinha
Kevin C
KC
Ward
Otis W
OW
Brawley
Joseph
J
Lipscomb
Christopher R
CR
Flowers
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D005006:Ethnicity; D005260:Female; D006801:Humans; D015994:Incidence; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018426:SEER Program; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology / Q000208:ethnology; D055815:Young Adult
End Results program; Epidemiology; Surveillance; diffuse large B-cell lymphoma; incidence; race; survival