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

Clin Lymphoma Myeloma Leuk. 2015 Oct;15(10):578-85. doi: 10.1016/j.clml.2015.06.005. Epub 2015 Jun 19.

Abstract

Background: As of 2013, more than 550,000 people are living with non-Hodgkin lymphoma (NHL).

Patients and methods: 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.

Results: 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).

Conclusion: 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.

Keywords: Ethnic and racial minorities; NHL; Outcome; Survival; Treatment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Asian
  • Black or African American
  • Female
  • Healthcare Disparities*
  • Hispanic or Latino
  • 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
  • Proportional Hazards Models
  • SEER Program
  • Treatment Outcome
  • United States / epidemiology
  • White People
  • Young Adult