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Initial cancer treatment and survival in children, adolescents and young adults with Hodgkin lymphoma: A population-based study
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12 15 2021
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Source: Cancer. 127(24):4613-4619
[PDF-266.81 KB]
Details:
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Alternative Title:Cancer
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Personal Author:
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Description:Background:
Hodgkin lymphoma (HL) is a treatable tumor affecting children, adolescents, and young adults (AYA; 15 – 39 years). Population-based studies report worse survival in non-White children and AYAs but have limited data on individual therapeutic exposures. We examined overall and HL-specific survival in a population-based cohort of patients while adjusting for sociodemographic factors and treatment.
Methods:
Data for 4,807 patients <40 years with HL (2007 – 2017) were obtained from the California Cancer Registry. Individual treatment information was extracted from text fields; chemotherapy regimens were defined by standard approaches for pediatric and adult HL. Multivariable Cox models examined the influence of patient and treatment factors on survival.
Results:
At median follow-up of 4.4 years, 95% of patients were alive. Chemotherapy differed by age, with 70% of 22–39 vs. 41% of <22-year-olds receiving ABVD (p<0.001). In multivariable models, older (22 – 39 vs. <22y; hazard ratio (HR): 1.52, 95% confidence interval (CI): 1.10, 2.09), Black (vs. White; HR: 1.90, 95%CI 1.25, 2.88) and Hispanic (HR: 1.48, 95%CI: 1.07, 2.03) patients experienced worse survival; among those <22 years, older age (15 – 21) was associated with 1.2-fold increased risk of death (HR: 1.22, 95%CI 1.02, 1.46) and Black race was associated with 3.6-fold increased risk of death (HR: 3.64, 95%CI 1.48, 8.95).
Conclusion:
In children and AYAs with HL, older age and non-White race/ethnicity predicted worse survival after adjusting for treatment data. Further work is needed to identify biologic and non-biologic factors driving disparities in these at-risk populations.
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Pubmed ID:34494662
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Pubmed Central ID:PMC8665020
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Volume:127
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Issue:24
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