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Racial and Ethnic Disparities in the Pediatric Hodgkin Lymphoma Population.
Pediatr Blood Cancer 2016; 63(3):428-35PB

Abstract

BACKGROUND

Little is known about the association between race/ethnicity and survival in pediatric Hodgkin lymphoma (HL) patients. In a state-wide pediatric cohort diagnosed with HL, we assessed demographic, disease, and treatment characteristics associated with overall survival (OS). We then attempted to validate these findings and assess disease-specific survival (DSS) in a national Surveillance, Epidemiology, and End Results (SEER) cohort.

PROCEDURE

HL patients of 0.1-21 years diagnosed from 1981 to 2010 were evaluated using the Florida Cancer Data System (FCDS). Kaplan-Meier curves estimated OS from 5 to 25 years based on race/ethnicity, treatment, decade of diagnosis, and sex. Multivariate Cox proportional hazard regressions tested independent factors associated with differences in OS. These methods were replicated in the SEER with additional assessment of DSS.

RESULTS

A total of 1,778 patients were identified in the FCDS and 6,027 in the SEER. Median diagnosis age was 17 years in both cohorts. In the FCDS, Blacks had worse OS than Whites and Hispanics at 25 years (33% vs. 49.2% vs. 44.7%, respectively; P = 0.0005), and Black race was associated with inferior OS on multivariate regression (hazard ratio [HR]: 1.81, P = 0.0003). In the SEER, Blacks had inferior OS (Blacks 74.2% vs. Whites 82% vs. Hispanics 82%; P = 0.0005) and DSS (85.7% vs. 90.8% vs. 88.1%, respectively; P = 0.0002) at 25 years. Hispanic males had inferior DSS compared to White males (84.8% vs. 90.6%; P = 0.0478), and Hispanic race was a predictor for inferior DSS on multivariate analysis (HR: 1.238; P < 0.0001).

CONCLUSIONS

Racial/ethnic disparities persist in the pediatric HL population despite modern treatment; underlying causes of these disparities are complex and need further examination.

Authors+Show Affiliations

Department of Radiation Oncology, University of Miami, Miami, Florida.Department of Radiation Oncology, University of Miami, Miami, Florida.Department of Radiation Oncology, University of Miami, Miami, Florida.Department of Epidemiology and Public Health, University of Miami, Miami, Florida.Cancer Research, Sylvester Cancer Center, University of Miami, Miami, Florida.Department of Radiation Oncology, University of Miami, Miami, Florida.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26524117

Citation

Grubb, W R., et al. "Racial and Ethnic Disparities in the Pediatric Hodgkin Lymphoma Population." Pediatric Blood & Cancer, vol. 63, no. 3, 2016, pp. 428-35.
Grubb WR, Neboori HJ, Diaz AD, et al. Racial and Ethnic Disparities in the Pediatric Hodgkin Lymphoma Population. Pediatr Blood Cancer. 2016;63(3):428-35.
Grubb, W. R., Neboori, H. J., Diaz, A. D., Li, H., Kwon, D., & Panoff, J. (2016). Racial and Ethnic Disparities in the Pediatric Hodgkin Lymphoma Population. Pediatric Blood & Cancer, 63(3), pp. 428-35. doi:10.1002/pbc.25802.
Grubb WR, et al. Racial and Ethnic Disparities in the Pediatric Hodgkin Lymphoma Population. Pediatr Blood Cancer. 2016;63(3):428-35. PubMed PMID: 26524117.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial and Ethnic Disparities in the Pediatric Hodgkin Lymphoma Population. AU - Grubb,W R, AU - Neboori,H J, AU - Diaz,A D, AU - Li,H, AU - Kwon,D, AU - Panoff,Joseph, Y1 - 2015/11/02/ PY - 2015/02/23/received PY - 2015/09/23/accepted PY - 2015/11/3/entrez PY - 2015/11/3/pubmed PY - 2016/6/14/medline KW - Hodgkin's lymphoma KW - SEER KW - epidemiology KW - long-term survival KW - lymphoma KW - pediatric oncology SP - 428 EP - 35 JF - Pediatric blood & cancer JO - Pediatr Blood Cancer VL - 63 IS - 3 N2 - BACKGROUND: Little is known about the association between race/ethnicity and survival in pediatric Hodgkin lymphoma (HL) patients. In a state-wide pediatric cohort diagnosed with HL, we assessed demographic, disease, and treatment characteristics associated with overall survival (OS). We then attempted to validate these findings and assess disease-specific survival (DSS) in a national Surveillance, Epidemiology, and End Results (SEER) cohort. PROCEDURE: HL patients of 0.1-21 years diagnosed from 1981 to 2010 were evaluated using the Florida Cancer Data System (FCDS). Kaplan-Meier curves estimated OS from 5 to 25 years based on race/ethnicity, treatment, decade of diagnosis, and sex. Multivariate Cox proportional hazard regressions tested independent factors associated with differences in OS. These methods were replicated in the SEER with additional assessment of DSS. RESULTS: A total of 1,778 patients were identified in the FCDS and 6,027 in the SEER. Median diagnosis age was 17 years in both cohorts. In the FCDS, Blacks had worse OS than Whites and Hispanics at 25 years (33% vs. 49.2% vs. 44.7%, respectively; P = 0.0005), and Black race was associated with inferior OS on multivariate regression (hazard ratio [HR]: 1.81, P = 0.0003). In the SEER, Blacks had inferior OS (Blacks 74.2% vs. Whites 82% vs. Hispanics 82%; P = 0.0005) and DSS (85.7% vs. 90.8% vs. 88.1%, respectively; P = 0.0002) at 25 years. Hispanic males had inferior DSS compared to White males (84.8% vs. 90.6%; P = 0.0478), and Hispanic race was a predictor for inferior DSS on multivariate analysis (HR: 1.238; P < 0.0001). CONCLUSIONS: Racial/ethnic disparities persist in the pediatric HL population despite modern treatment; underlying causes of these disparities are complex and need further examination. SN - 1545-5017 UR - https://www.unboundmedicine.com/medline/citation/26524117/Racial_and_Ethnic_Disparities_in_the_Pediatric_Hodgkin_Lymphoma_Population_ L2 - https://doi.org/10.1002/pbc.25802 DB - PRIME DP - Unbound Medicine ER -