Non-Hispanic black and Hispanic (nonwhite) pediatric patients with Hodgkin lymphoma have a higher rate of postrelapse mortality, according to research published in the Journal of Clinical Oncology. These results confirm suspected survival disparities based on patient ethnicity and held true after adjustment for factors including neighborhood socioeconomic status and type of treatment.
Despite significant improvements in 5-year survival among pediatric patients with lymphoma, including among those with relapsed disease, some research suggests that Hispanic and non-Hispanic black patients have higher relapse and mortality rates than do white patients.
For this study, researchers evaluated data from 1605 patients enrolled in phase 3 Children’s Oncology Group trials for treatment of Hodgkin lymphoma. Patient ages were younger than 1 year through 21 years (mean, 14.6 years), 522 (33%) were nonwhite, and the majority (59%) had stage II disease.
Multivariable analyses showed that being of nonwhite ethnicity was associated with worse overall survival (OS; hazard ratio [HR], 0.92; P =.54) but not 5-year event-free survival (EFS; HR, 1.88; P =.14). Postrelapse OS was significantly worse in both Hispanic (HR, 2.72; P =.018) and non-Hispanic black patients (HR, 3.45; P =.005).
“Compared with non-Hispanic white patients, non-Hispanic black and Hispanic patients in our cohort had between 2.7-fold and 3.5-fold higher hazards of postrelapse mortality, regardless of adjustment for neighborhood socioeconomic status,” the authors wrote.
White, Hispanic, and non-Hispanic black patients had 5-year postrelapse OS rates of 90%, 80%, and 66%, respectively (P <.01).
“Given the findings of this work, it is imperative that simultaneous efforts [focus] on improving health equity, expanding clinical trial participation, and identifying drivers of racial and ethnic disparities in children with relapsed disease,” the authors concluded.
1. Kahn JM, Kelly KM, Pei Q, et al. Survival by race and ethnicity in pediatric and adolescent patients with Hodgkin lymphoma: a Children’s Oncology Group Study [published online September 20, 2019]. J Clin Oncol. doi:10.1200/JCO.19.00812