Comparative Outcomes Between Black and White Patients With Early-Stage Diffuse Large B-Cell Lymphoma.

Area of Science:

• Hematology
• Oncology
• Epidemiology

Background:

• Diffuse Large B-cell Lymphoma (DLBCL) survival rates are generally worse for Black patients and in advanced stages.
• Existing research has not specifically evaluated race and socioeconomic factors in early-stage DLBCL outcomes.
• A research gap exists in understanding survival determinants for early-stage DLBCL concerning race.

Purpose of the Study:

• To compare characteristics and survival determinants between Black and White patients with early-stage (I-II) DLBCL.
• To investigate the impact of race on survival in early-stage DLBCL.
• To identify factors influencing survival in early-stage DLBCL across racial groups.

Main Methods:

• Retrospective analysis of the National Cancer Database (NCDB) for early-stage DLBCL patients (2004-2017).
• Comparison of sociodemographic, clinical, and treatment factors between Black and White patient cohorts.
• Multivariate Cox regression and Kaplan-Meier analyses to identify survival predictors and compare survival outcomes by race.

Main Results:

• The study included 81,430 early-stage DLBCL patients (5,709 Black, 75,721 White).
• Factors associated with higher mortality risk included male sex, age ≥60, ≥2 comorbidities, B symptoms, HIV infection, and lower income.
• No significant difference in overall survival was observed between Black and White patients (HR 0.98, p=0.5263).

Conclusions:

• Despite socioclinical disparities, Black and White patients with early-stage DLBCL exhibit similar survival rates.
• Favorable remission rates and access to chemoimmunotherapy likely mitigate survival differences in early-stage DLBCL.
• Survival disparities observed in DLBCL may be more pronounced in advanced stages (III-IV) due to socioclinical determinants.