The impact of race and ethnicity on diffuse large B-cell lymphoma outcomes within the veterans health administration (VHA)

Leuk Lymphoma. 2024 Aug;65(8):1090-1099. doi: 10.1080/10428194.2024.2338856. Epub 2024 Apr 15.

Abstract

We performed a retrospective chart review of 6266 randomly selected DLBCL patients treated in the VHA nationwide between 1/1/2011 and 12/31/2021. The 3178 patients who met inclusion criteria were predominantly male (97%) and white (75%). Median age of diagnosis for Black patients was 63 years vs 69 years for the entire cohort (p < 0.001). However, patients in each race/ethnicity subgroup presented with similar rates of stage I/II and III/IV disease, IPI score, cell of origin and HIT status. Outcomes analysis revealed similar treatment, response rates, median overall survival, and 1-, 3-, and 5-year survival across all subgroups. Hispanic patients had a 21% lower risk of death (HR = 0.79) than white patients, and Black patients had no significant difference in survival (HR = 0.98). This large retrospective study shows that when standard of care therapy is given within an equal access system, short-term treatment and survival outcomes are the same for all races.

Keywords: African Americans; Hispanics; Lymphoma and Hodgkin disease; diffuse large B-cell lymphoma; disparities; health disparities.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Ethnicity* / statistics & numerical data
  • Female
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / ethnology
  • Lymphoma, Large B-Cell, Diffuse* / mortality
  • Lymphoma, Large B-Cell, Diffuse* / therapy
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Racial Groups / statistics & numerical data
  • Retrospective Studies
  • Treatment Outcome
  • United States / epidemiology
  • United States Department of Veterans Affairs* / statistics & numerical data