Despite modern treatment, African-American pediatric Hodgkin lymphoma patients have inferior survival to their white and Hispanic peers. These findings come from the largest study yet on racial and ethnic disparity in the pediatric Hodgkin lymphoma population published in Pediatric Blood & Cancer.1
“Little was known about the association between race, ethnicity, and survival in the pediatric Hodgkin lymphoma population,” said Joseph Panoff, MD, a radiation oncologist at Sylvester Cancer Center at the University of Miami in Florida and lead author of the study.
“Our study showed that African-American children and teenagers had worse overall survival than whites and Hispanics at 25 years after diagnosis. We also found that Hispanic males had inferior disease-specific survival compared to white males.”
Lymphoma is the third most common malignancy in children and adolescents in the United States, and about half of all lymphoma diagnoses are Hodgkin lymphoma. Current 5-year survival rates average 95% for patients aged 0 to 19 years with Hodgkin lymphoma.
This study analyzed Florida-specific data as well as national data from more than 7800 patients, aged 0.1 to 21 years (average: 17 years), who were listed in the Florida Cancer Data System (FCDS) and the National Institutes of Health’s Surveillance, Epidemiology, and End Results Program (SEER). The analysis included all Hispanics, non-Hispanic whites, and non-Hispanic African-Americans.
The Florida (FCDS) cohort of 1778 patients was significantly smaller than the SEER cohort of 6027 patients. The African-Americans in the FCDS cohort had a 33% overall survival rate at 25 years compared to 49.2% for whites and 44.7% for Hispanics. Overall, the FCDS cohort seemed to have worse overall survival than the SEER cohort, indicating that national outcomes are better than those of patients treated in Florida.
“Clearly, racial and ethnic disparities persist in the pediatric Hodgkin lymphoma population despite modern treatment, particularly in Florida,” Dr Panoff added. “The underlying causes of these disparities are complex and need further explanation.”
Dr Panoff suggested further research seeking to identify flaws within the diagnostic and treatment process with regard to African-American and Hispanic patients.
“It is important to identify sociocultural factors and health behaviors that negatively affect overall survival in African-American patients and disease-free survival in Hispanic males,” said Dr Panoff. “The fact that the entire Florida cohort seems to have worse overall survival than patients in the rest of the country is a new finding that requires further research.”
1. Grubb WR, Neboori HJ, Diaz AD, et al. Racial and ethnic disparities in the pediatric Hodgkin lymphoma population. N Engl J Med. 2016;63(3):428-435.