title: Survival in advanced diffuse large B-cell lymphoma in pre- and post-rituximab Eras in the United States.
abstract: BACKGROUND
  Rituximab was approved by the United States Food and Drug Administration (FDA) as a first-line agent for treatment of advanced diffuse large B-cell lymphoma (DLBCL) in February 2006. We conducted this population-based study to determine if the results from the clinical trials have translated into survival benefit in the general population.
  
  
  METHODS
  We selected patients with advanced diffuse large B-cell lymphoma from the Surveillance, Epidemiology, and End RESULTS (SEER) 18 database, and calculated relative survival rates for patients diagnosed from 2002-2005 (pre-rituximab) and 2006-2009 (post-rituximab). We used the Z-test in the SEER*Stat to compare relative survival rates of patients categorized by race (White, Black, or Others), gender (male, female), and age groups (<60, 60+ years).
  
  
  RESULTS
  One-year relative survival in Whites and Others improved significantly in the post-rituximab era compared to the pre-rituximab era (64.80±0.6% vs. 61.3±0.6%; p=0.0002 and 64.5±1.9% vs. 54.9±2.2%; p=0.0011, respectively). The 3-year relative survival improved significantly in Whites and Others in the post-rituximab era compared to the pre-rituximab era (53.7±0.7% vs. 50.3±0.7%; p=0.0001 and 52.0±2.3% vs. 40.8±2.3%; p=0.0002, respectively). However, no significant improvements were observed in 1-year and 3-year relative survival in Blacks, and in young males during the post-rituximab era compared to the pre-rituximab era.
  
  
  CONCLUSIONS
  The relative survival rates among young males and 'Black' patients with advanced diffuse large B-cell lymphoma have not improved during the post-rituximab era.
authors.affiliation: Cancer Center and Blood Institute, St Joseph Regional Medical Center, Lewiston, ID, U.S.A. binay.shah@gmail.com.
authors.forename: Binay Kumar
authors.initials: BK
authors.lastname: Shah
authors.affiliation: Cancer Center and Blood Institute, St Joseph Regional Medical Center, Lewiston, ID, U.S.A.
authors.forename: Amir
authors.initials: A
authors.lastname: Bista
authors.affiliation: Department of Statistical Sciences, University of Idaho, Moscow, ID, U.S.A.
authors.forename: Bahman
authors.initials: B
authors.lastname: Shafii
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009367:Neoplasm Staging; D000069283:Rituximab; D018426:SEER Program; D012737:Sex Factors; D014481:United States / Q000453:epidemiology
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab
keywords: Diffuse large B-cell lymphoma; SEER; rituximab; survival