Posted: Friday, June 17, 2022
Results from the largest racial disparity study to date in diffuse large B-cell lymphoma (DLBCL) suggest that overall survival is substantially shorter for Black patients than for White patients, according to findings presented at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 7507). In addition, Daniel Arthur Ermann, MD, of the Huntsman Cancer Institute in Salt Lake City, and colleagues found that aligning patients’ surrogate health-care indicators, such as median income and insurance status, reduced this disparity to the point of nonsignificance.
“Further studies into examining these racial differences are warranted to optimize care for all DLBCL patients,” concluded the authors.
The study used the National Cancer Database to identify 223,709 patients identified with DLBCL between 2004 and 2018. Of those included, 87% were White, 8% were Black, and 5% were of another race. In comparison to White patients, Black patients tended to be younger (mean age 56 vs. 66), more likely to have at least one comorbidity (33% vs. 27%), more likely to be human immunodeficiency virus (HIV)-positive (26% vs. 5%), and more likely to have both B symptoms (40% vs. 30%) and stage IV disease (42% vs. 37%). Uninsured status (8% vs. 3%) and categorization in the lowest median income quartile (43% vs. 15%) were also more common in Black patients than in White patients. Furthermore, Black patients were found to be more likely to receive care at academic medical centers (50% vs. 36%).
Multivariate analysis revealed an association between Black racial identity and poorer overall survival; however, propensity-matched analysis did not identify a meaningful difference between overall survival outcomes in Black versus White patients. At a median follow-up of 44.9 months, the median overall survival for patients who were HIV-negative was 109 months. Median, 5-year, and 10-year overall survival rates were worse for Black patients aged 60 or younger than for White patients in that age group (46 vs. 76 months, 73% vs. 75%, and 65% vs. 69%, respectively).
Disclosure: For full disclosures of the study authors, visit coi.asco.org.