title: Outcome disparities among ethnic subgroups of Waldenström's macroglobulinemia: a population-based study.
abstract: BACKGROUND
  Ethnic disparities in cancers are associated with variability in clinical outcomes. We present a Surveillance Epidemiology and End RESULTS (SEER)-based outcome analysis of multiethnic Waldenström's macroglobulinemia (WM) patients.
  
  
  METHODS
  Adult WM patients diagnosed in 1992 or later (n = 3,175) were analyzed. Median overall survival (OS) was compared across different ethnicities stratified by year of diagnosis, registry identification, age at diagnosis, sex, and marital status.
  
  
  RESULTS
  African-Americans (AA) had the youngest median age at diagnosis (63 years) and Whites had the oldest (73 years) (p < 0.001). Female gender, a younger age at diagnosis, and a recent year of diagnosis were associated with an improved OS. Hispanics had the worst (5.6 years) while Whites had the best (6.8 years) median OS. A significant interaction existed between median OS, gender, and race (p = 0.007). Among males, AA had the worst (4.3 years) and Asians had the best (7.3 years) median OS. A significant interaction was also noted between median OS, age at diagnosis, and race (p = 0.033). The worst median OS was seen in Hispanics among patients aged >75 years, and in AA among those aged <65 years.
  
  
  CONCLUSIONS
  These disparities among WM patients may be multifactorial but need to be explored systematically to better understand the disease biology and for optimal triaging of health care resources.
authors.affiliation: Division of Hematology and Oncology, Mayo Clinic, Jacksonville, Fla., USA.
authors.forename: Sikander
authors.initials: S
authors.lastname: Ailawadhi
authors.forename: Adel
authors.initials: A
authors.lastname: Kardosh
authors.forename: Dongyun
authors.initials: D
authors.lastname: Yang
authors.forename: Wendy
authors.initials: W
authors.lastname: Cozen
authors.forename: Gaurav
authors.initials: G
authors.lastname: Patel
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Alamgir
authors.forename: Asher A
authors.initials: AA
authors.lastname: Chanan-Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D018426:SEER Program; D017678:Sex Distribution; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D008258:Waldenstrom Macroglobulinemia / Q000188:drug therapy / Q000208:ethnology* / Q000401:mortality; D044465:White People; D055815:Young Adult