Racial Disparities in Overall Survival of Diffuse Large B-cell Lymphoma
Black patients with diffuse large B-cell lymphoma (DLBCL) have worse overall survival (OS) outcomes when compared with White patients, despite having similar diagnostic scores and a similar likelihood to receive multi-agent chemotherapy.
The results of this study were presented at the American Society for Clinical Oncology’s 2022 annual meeting.
“We present the largest study to date examining racial disparities in DLBCL,” researchers wrote.
Included were 223,709 patients from the National Cancer Database who were diagnosed with DLBCL from 2004 to 2018. Of the total participants, 87% were White patients, 8% were Black patients, and 5% were other. Black patients were more likely to have 1 or more comorbidities, be HIV-positive, have both B-symptoms, and stage IV disease, and were younger than White patients. This group was also more likely to be uninsured, in the lowest median income quartile, and to receive treatment at academic centers.
The median OS for Black patients aged 60 years or younger was 46 months. White patients of the same age group had a median OS of 76 months. Black patients of this age group also had worse 5- and 10-year OS than White patients (73% vs 75%, and 65% vs 69%, respectively). Similar results were observed for the group aged 61 to 79 years, but not among patients 80 years or older.
Black race was also independently associated with worse OS on a multivariate analysis (HR 1.06; 95% CI, 1.01-1.10, P = .90). There was no significant difference in OS between Black and White patients on the propensity matched analysis (median 127 vs 117 months; HR 1.0; CI 0.94-1.06, P = .90).
“This data demonstrates that Black patients have significantly shorter OS compared to White patients, which persists on multivariate analysis,” they concluded. “However, this disparity in survival became nonsignificant when patients are equally matched on surrogate markers of health care access such as insurance status and median income. Further studies into examining these racial differences are warranted to optimize care for all DLBCL patients.”
Ermann DA. Racial disparities affecting Black patients with diffuse large B-cell lymphoma. Talk presented at: 2022 ASCO Annual Meeting; June 3-7, 2022; Chicago, IL. Accessed June 9, 2022. https://meetings.asco.org/abstracts-presentations/207250