TY - JOUR
T1 - Effect of race on the outcome of pediatric patients with Hodgkin's lymphoma
AU - Metzger, Monika L.
AU - Castellino, Sharon M.
AU - Hudson, Melissa M.
AU - Rai, Shesh N.
AU - Kaste, Sue C.
AU - Krasin, Matthew J.
AU - Kun, Larry E.
AU - Pui, Ching Hon
AU - Howard, Scott C.
PY - 2008/3/10
Y1 - 2008/3/10
N2 - Purpose: Some cooperative groups have found a survival disadvantage in black children with various childhood cancers. We examine the effects of race on clinical outcomes among children with Hodgkin's lymphoma (HL) treated with contemporary therapy at a tertiary care children's hospital. Patients and Methods: Retrospective analysis of 327 children and adolescents diagnosed with HL between 1990 and 2005. Patients were treated with risk-directed multimodal therapy regardless of race, ethnicity, or ability to pay. Event-free and overall survival rates were compared for black and white children. Clinical characteristics, socioeconomic factors, and biologic features were analyzed for prognosis of treatment failure. Results: The 262 white and 65 black patients did not differ significantly in presenting features, clinical characteristics, or enrollment in a clinical trial. More black patients (71% v 45%) resided in poor counties (P < .001). While black and white children were equally likely to have progressive disease or early relapse, black children were 3.7 times (95% CI, 1.7 to 8.0) more likely to relapse 12 months or more after diagnosis. The 5-year event-free survival was 71% ± 6.1% (SE) for black and 84% ± 2.4% for white children (P = .01). However, the 5-year survival rate did not differ between white and black children (94.4% v 94.7%). While black race and low hemoglobin concentration were independent predictors of treatment failure, only low hemoglobin concentration independently predicted poor survival. Conclusion: Black children with Hodgkin's lymphoma have lower event-free survival than white children, but both populations have the same 5-year overall survival.
AB - Purpose: Some cooperative groups have found a survival disadvantage in black children with various childhood cancers. We examine the effects of race on clinical outcomes among children with Hodgkin's lymphoma (HL) treated with contemporary therapy at a tertiary care children's hospital. Patients and Methods: Retrospective analysis of 327 children and adolescents diagnosed with HL between 1990 and 2005. Patients were treated with risk-directed multimodal therapy regardless of race, ethnicity, or ability to pay. Event-free and overall survival rates were compared for black and white children. Clinical characteristics, socioeconomic factors, and biologic features were analyzed for prognosis of treatment failure. Results: The 262 white and 65 black patients did not differ significantly in presenting features, clinical characteristics, or enrollment in a clinical trial. More black patients (71% v 45%) resided in poor counties (P < .001). While black and white children were equally likely to have progressive disease or early relapse, black children were 3.7 times (95% CI, 1.7 to 8.0) more likely to relapse 12 months or more after diagnosis. The 5-year event-free survival was 71% ± 6.1% (SE) for black and 84% ± 2.4% for white children (P = .01). However, the 5-year survival rate did not differ between white and black children (94.4% v 94.7%). While black race and low hemoglobin concentration were independent predictors of treatment failure, only low hemoglobin concentration independently predicted poor survival. Conclusion: Black children with Hodgkin's lymphoma have lower event-free survival than white children, but both populations have the same 5-year overall survival.
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U2 - 10.1200/JCO.2007.14.0699
DO - 10.1200/JCO.2007.14.0699
M3 - Article
C2 - 18323551
AN - SCOPUS:41649095013
SN - 0732-183X
VL - 26
SP - 1282
EP - 1288
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 8
ER -