Diffuse large B-cell lymphoma (DLBCL) in African American patients: A retrospective study of clinical, molecular, and therapeutic differences in a sample population treated at UAB Comprehensive Cancer Center (UAB CCC)

Autor: A. S. The, V. Reddy, Y. Li, R. Davis, M. Baird, J. M. Foran
Rok vydání: 2007
Předmět:
Zdroj: Journal of Clinical Oncology. 25:21035-21035
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.2007.25.18_suppl.21035
Popis: 21035 Background: SEER registry data indicate African Americans (AA) have a lower incidence of non-Hodgkin's lymphoma (NHL) but face higher lymphoma-specific mortality rates than Caucasians (C). To investigate this we compared outcomes between AA & C patients (pts) with DLBCL treated at UAB CCC. Correlative histologic & molecular studies of established prognostic features were performed to investigate differences. Methods: After IRB approval, DLBCL pts diagnosed '95-'06 were identified from pathology & referral databases. Baseline demographic & clinical data were extracted, including treatment (Rx), response & survival. Expression patterns of CD10, bcl-6, & MUM-1 were used to identify germinal center B-cell-like (GCB) vs non-GCB molecular subtype of DLBCL based on algorithm of Hans et al (2004). HLA-DR, bcl-2, & CD138 expression was determined. A 2:1 age- & gender-matched comparison of C to A pts was performed to evaluate differences. Descriptive analysis with X2 & Wilcoxon nonparametric tests & Kaplan Meier survival analysis were performed to determine differences. Results: 188 DLBCL patients were identified. Race was noted in 129, including 18 AA pts (14%). In comparison to 36 C pts (2:1 match), no differences were seen in LDH or stage at presentation. AA pts achieved better response to 1st-line Rx (p=0.01) & received fewer regimens (1 vs >1, p=0.05), however they were more likely to receive rituximab with 1st-line Rx (p=0.02), likely reflecting presentation in the post-rituximab era. Median survival, not yet reached for AA's, was 23 months for C pts (p=0.0509). Univariate & parametric survival analyses demonstrated LDH (p=0.0217) & 1st-line rituximab (p=0.0048) independently affected survival. In a separate cohort, no significant difference between races was seen in frequency of GCB vs non-GCB subtype or in expression of bcl-2, CD-138, or HLA-DR. Conclusions: Contrary to SEER observations, the outcome of AA DLBCL pts was superior to C pts in this single center study. No molecular or clinical prognostic feature dominated in either race. The fact that more AA than C patients received rituximab upfront confirms the benefit of adding this agent to 1st-line Rx. No significant financial relationships to disclose.
Databáze: OpenAIRE
Externí odkaz: