Persistent Disparities Among Patients With T-Cell Non-Hodgkin Lymphomas and B-Cell Diffuse Large Cell Lymphomas Over 40 Years: A SEER Database Review

• Published in: Clinical lymphoma, myeloma and leukemia Vol. 15; no. 10; pp. 578 - 585
• Main Authors: Crozier, Jennifer A., Sher, Taimur, Yang, Dongyun, Swaika, Abhisek, Foran, James, Ghosh, Radhika, Tun, Han, Colon-Otero, Gerardo, Kelly, Kevin, Chanan-Khan, Asher, Ailawadhi, Sikander
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2015
• Subjects: Adolescent; Adult; African Americans; Aged; Asian Americans; Ethnic and racial minorities; European Continental Ancestry Group; Female; Healthcare Disparities; Hematology, Oncology and Palliative Medicine; Hispanic Americans; Humans; Lymphoma, Large B-Cell, Diffuse - ethnology; Lymphoma, Large B-Cell, Diffuse - mortality; Lymphoma, Large B-Cell, Diffuse - therapy; Lymphoma, T-Cell - ethnology; Lymphoma, T-Cell - mortality; Lymphoma, T-Cell - therapy; Male; Middle Aged; NHL; Outcome; Proportional Hazards Models; SEER Program; Survival; Treatment; Treatment Outcome; United States - epidemiology; Young Adult; United States; NHL; Treatment; Survival; Ethnic and racial minorities; Outcome
• ISSN: 2152-2650; 2152-2669; 2152-2669
• DOI: 10.1016/j.clml.2015.06.005

Our population-based analysis for T-cell and B-cell non-Hodgkin lymphoma (NHL) in the novel therapeutic agent era showed worse median overall survival (OS) for male subjects, older patients, and ethnic minorities for both T-cell and B-cell NHL. Despite novel therapeutics targeting T cells, there has been no statistically significant improvement in OS over time, in contrast to the significant improvement in B-cell NHL OS, presumably as a result of the advent of monoclonal antibodies. As of 2013, more than 550,000 people are living with non-Hodgkin lymphoma (NHL). We undertook a large Surveillance Epidemiology and End Results (SEER) based analysis to describe outcome disparities in different subgroups of aggressive T-cell and B-cell NHL patients, with a focus on various ethnicities. The final analysis included 7662 patients with T-cell and 84,910 with B-cell NHL. Survival analysis revealed that male sex and increasing age were independent predictors of worse overall survival (OS; P < .001). For aggressive T-cell NHL, there was no significant improvement in median OS between 1973 and 2011 (P = .081), and ethnic minorities (Asians, Hispanics, and African Americans) had significantly worse OS than whites (P < .001). There were similar trends for age, sex, and race for diffuse large B-cell NHL, but a significant improvement in median OS was seen over time (P < .001). These results are the first to elicit outcomes in a broad classification of ethnic minorities and underscore the urgency for development of novel therapeutics, especially in T-cell NHL. In addition, in-depth studies of disease biology and health care utilization are required for better triage of health care resources, especially for ethnic minorities.