(S054) Long-Term Survival and Racial Differences in Pediatric Hodgkin Lymphoma Patients From the State of Florida: Three Decades of Experience

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OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

This is the largest retrospective review with the longest outcome to specifically evaluate pediatric Hodgkin lymphoma patients. Furthermore, this is the first analysis to find that AA patients have inferior OS when compared with whites and Hispanics. These differences remained significant over the course of 30 years, indicating that modern treatment modalities have not improved this racial disparity.

Hanmanth Neboori, MD, William Grubb, BS, Hua Li, PhD, MD, Joseph Panoff; University of Miami/Jackson Health System

PURPOSE/METHODS: Hodgkin lymphoma (HL) represents 9% of all pediatric malignancies in the United States. Data are conflicting with regard to racial/ethnic survival differences. We sought to investigate overall survival (OS) differences in a large cohort of racially and ethnically diverse patients with 30 years of follow-up in the state of Florida.

METHODS: The Florida Cancer Database System was used to retrospectively assess the long-term outcomes of 1,778 pediatric patients (age range: 1 mo–21 yr) diagnosed with HL between 1981 and 2010. Log-rank test and Cox univariate and multivariate regression analysis were used to identify predictors of OS.

RESULTS: Median age at diagnosis was 1.7 years (range: 0.1–21 mo). Males and females were equally represented (50.5% vs 49.5%). The database consisted of 68% white, 13% African American (AA), 18% Hispanic, and 2% unknown. The breakdown of diagnosis by decade was as follows: 27% from 1981–1990; 31% from 1991–2000; and 42% from 2000–2010. There were 16% of patients diagnosed as stage I, 42% diagnosed as stage II, 31% diagnosed as stages III and IV, and 11% unknown. Nodular sclerosing was diagnosed in 69% of patients, mixed cellularity was diagnosed in 13%, lymphocyte-rich disease was diagnosed in 4%, lymphocyte-depleted (LD) disease was diagnosed in 2%, and nodular lymphocyte-predominant HL (NLPHL) was diagnosed in 2%. Radiation was administered in 43% of patients, and chemotherapy was given to 73% of patients. Median survival of the entire cohort at the time of last follow-up was 23.8 years. The 5-year OS rate was 84.2%. Men had worse OS than women at 25 years (36% vs 58%; P < .0001). AA patients had worse OS than white and Hispanic patients at 25 years (33% vs 49.2% vs 44.7%, respectively; P = .0005), and this finding persisted after controlling for decade of treatment (P < .001). There was no difference in OS between whites and Hispanics. There were no OS differences regarding decade of treatment, chemotherapy, or age at diagnosis. Patients who had radiation therapy had better OS (hazard ratio [HR] = 1.49; P = .0025). Additionally, patients with the LD subtype had worse OS (HR = 3.85; P = .01).

CONCLUSION: This is the largest retrospective review with the longest outcome to specifically evaluate pediatric Hodgkin lymphoma patients. Furthermore, this is the first analysis to find that AA patients have inferior OS when compared with whites and Hispanics. These differences remained significant over the course of 30 years, indicating that modern treatment modalities have not improved this racial disparity.

Proceedings of the 97th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
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