Survival worse for nonwhite children with Hodgkin lymphoma

(HealthDay)—Among children with Hodgkin lymphoma (HL) enrolled in phase III trials, nonwhite patients have an increased risk for death, according to a study published in the Nov. 10 issue of the Journal of Clinical Oncology.

Justine M. Kahn, M.D., from the Columbia University Irving Medical Center in New York City, and colleagues used individual-level data from 1,605 patients (<1 to 21 years) enrolled in phase III trials for low-, intermediate-, and high-risk HL from 2002 to 2012. For non-Hispanic white and nonwhite patients, event-free survival (EFS) and overall survival (OS) were compared.

The researchers found that the cumulative incidence of relapse was 17 percent at a median follow-up of 6.9 years. The unadjusted five-year EFS was 83 percent and OS was 97 percent. No difference in EFS was seen in unadjusted or adjusted analyses by race/ethnicity. Nonwhite patients had a 1.88-fold increased risk for death in multivariable analyses for OS. By race, the postrelapse survival probabilities were 90, 66, and 80 percent for non-Hispanic white, non-Hispanic black, and Hispanic children, respectively. The risk for postrelapse mortality was 2.7- and 3.5-fold higher for Hispanic and non-Hispanic black children, respectively, versus non-Hispanic white children.

“Given the findings of this work, it is imperative that simultaneous efforts are focused on improving health equity, expanding clinical trial participation, and identifying drivers of racial/ethnic disparities in children with relapsed disease,” the authors write.

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