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Racial differences in presentation and management of follicular non-Hodgkin lymphoma in the United States†
Report from the National LymphoCare Study
Article first published online: 20 MAR 2012
Copyright © 2012 American Cancer Society
Volume 118, Issue 19, pages 4842–4850, 1 October 2012
How to Cite
Nabhan, C., Byrtek, M., Taylor, M. D., Friedberg, J. W., Cerhan, J. R., Hainsworth, J. D., Miller, T. P., Hirata, J., Link, B. K. and Flowers, C. R. (2012), Racial differences in presentation and management of follicular non-Hodgkin lymphoma in the United States. Cancer, 118: 4842–4850. doi: 10.1002/cncr.27513
Presented in part as an oral session at the 49th Annual Meeting of the American Society of Hematology; December 8-11, 2007; Atlanta, Ga; and as an abstract and a poster at the 51st Annual Meeting of the American Society of Hematology; December 4-8, 2009; New Orleans, La.
- Issue published online: 19 SEP 2012
- Article first published online: 20 MAR 2012
- Manuscript Accepted: 1 FEB 2012
- Manuscript Revised: 25 JAN 2012
- Manuscript Received: 13 SEP 2011
- follicular lymphoma;
- racial disparities;
- African Americans;
- non-Hodgkin lymphoma
Racial differences in follicular lymphoma (FL) in the United States have not been investigated.
The National LymphoCare Study is a multicenter, longitudinal, observational cohort study collecting data on treatment patterns and outcomes for patients with newly diagnosed FL in the United States between 2004 and 2007 without any predefined, study-specific intervention. The authors investigated differences between white (W) patients, African American (AA) patients, and Hispanic (H) patients.
Among 2744 enrolled patients, there were 95 (3%) AA patients, 125 (5%) H patients, and 2476 (90%) W patients. Compared with W patients, more AA and H patients were diagnosed at age <45 years (P < .0001). H patients more commonly were diagnosed with grade 3 FL compared with AA and W patients (29%, 13%, and 18%, respectively; P = .019) and more commonly received rituximab plus chemotherapy as initial therapy compared with W patients (66% vs 50%; P = .036), while AA patients less commonly received anthracyclines (49% vs 64% in W patients; P = .027). H and AA patients who received rituximab plus chemotherapy were less likely than W patients to receive maintenance rituximab (27% vs 31% vs 40%, respectively; P = .031). At a median follow-up of 52 months, progression-free survival was similar between AA and W patients but was longer in H patients, and there was no difference in overall survival.
In the largest prospective cohort to date of AA and H patients with FL in the United States, AA and H patients were younger at presentation. Although racial differences in treatment patterns for FL were noted, additional follow-up is needed to determine the impact of these differences on survival. Cancer 2012. © 2012 American Cancer Society.