African American (AA) patients with diffuse large b-cell lymphoma (DLBCL) experience differences in outcomes that are varied and poorly understood. When compared to non-AA patients, AA patients present at younger ages frequently have more aggressive traits and have worse clinical outcomes. The traditional methods for risk-stratifying illness outcomes based on molecular characteristics and clinical prognostic tools can not reliably predict survival in patients of color. For a study, researchers sought to discuss clinical and medical issues linked to a poorer prognosis for AA patients with DLBCL.
They retrospectively analyzed patients who received diffuse large b-cell lymphoma (DLBCL) treatment at Ben Taub General Hospital and Baylor St. Luke’s Medical Center in Houston, Texas, for this study. Age between 18 and 65 years (y) and a pathology-confirmed DLBCL diagnosis served as inclusion criteria. The patient’s medical file contained the patient’s self-reported race. Immunohistochemistry or flow cytometry was used to identify CD10 positivity in the acquired samples. All analyses were performed with SAS statistical software. Descriptive statistics were used to characterize patient demographics, illness features, and clinical outcomes. A Cox regression model was utilized to assess the impact of independent factors on overall survival (OS) and event-free survival (EFS).
Of the 288 DLBCL patients they found, 57 self-identified as AA. The median age of non-AA patients was 53.7 (y) old at the time of treatment, compared to 49.1y for black patients. Compared to non-AA patients, a greater proportion of AA patients (31.4 vs. 18.8%, P=0.05) had a BMI >35 and had hemoglobin levels that were lower (mean 10.6 g/dL vs. 12.1 g/dL, P=0.002). At the time of diagnosis, there was bone marrow involvement in 14.4% of non-AA patients and 24% of AA patients (P=0.2). Fewer AA patients developed illness with CD10 expression (26.3% vs. 50%, P=0.05). AA patients and Non-AA patients both had similar percentages of patients with high-risk International Prognostic Index (IPI) values (19.8% and 34.7%, respectively) (P=0.6). Age-matched non-AA patients had a better OS than AA patients <65 y old, with median survival times of 8.0 years and not attained, respectively (P=0.01). Anemia’s independent additive influence (P=0.006) on AA’s worse outcome was confirmed by Cox regression.
The research showed that in AA patients with DLBCL, anemia was linked to a worse chance of survival. The results of AA patients in the cohort were consistent with prior research showing that pre-treatment anemia has a detrimental effect on survival in DLBCL. Although extreme obesity and a lack of CD10 expression may be associated with unfavorable outcomes, more extensive data were required to support the findings. The research supported a number of previously identified risk factors for worse survival in AA individuals with DLBCL. Studies were required to more clearly define the nontraditional/genomic elements causing the discrepancies in treatment outcomes in AA patients.