Do Hispanic individuals have similar overall survival of nodular lymphocyte-predominant Hodgkin’s lymphoma? A national analysis.
Authors: Mines Ian Michael , Velez Carolina , Liu Qianqian , Michalek Joel , Diaz Duque Adolfo Enrique 
Published: June 2023

e19512

Background: Nodular lymphocyte-predominant Hodgkin’s Lymphoma (NLPHL) is a rare subtype of Hodgkin’s Lymphoma (HL) accounting for approximately 5% of all cases of HL in the United States (US). (PMID: 29763144 ) The prognosis overall for NLPHL is exceptionally good. (PMID: 34923571) Much of the clinical outcome data for NLPHL is from European countries or the US without racial sub-group analysis available. (PMID: 34923571, PMID: 33976110, PMID: 29222274 ) Few studies examine if there are disparities in outcomes nationally within each HL subtype when comparing Hispanics and non-Hispanics. (PMID: 22241896, PMID: 26198444) This study looks at the impact of ethnicity across several key variables and the survival outcomes of this cancer in Hispanics (HI) compared to Non-Hispanics (NH) within the US, using Surveillance, Epidemiology, and End Results (SEER) database. Methods: Data was analyzed on NLPHL patients in the US and reported to the SEER database between 2000 -2018. Patient demographics, survival, and clinical course were evaluated with Kaplan-Meier, Cox regression, multivariate analysis, and propensity score matching. Results: 2,532 of NLPHL patients, 11% were HI, and 89% were NH. > 65% of those diagnosed were male in both groups. HI pts were younger, with a median age of 35 years old vs 45 years old (p < 0.001); the majority of HI (55%) were diagnosed in the age bracket of < 40 years old vs the majority of NH 42% were diagnosed in the age bracket of < 40 years old (p = < 0.001) Both groups had a majority of diagnosis during the years 2015-2018 (p = 9.18). Regarding race, most of HI and NH were whites 89% vs 68%, followed by blacks 6% vs 26%. Both groups were most commonly Stage at the time of diagnosis ~30% (0.584). In terms of radiation therapy rates were similar ~37% (p = 0.287) On survival analysis, the survival probability at 2, 5, and 10 years of HI vs NH was 93% vs 96%, 89% vs 92%, and 84% vs 80%, respectively. The median survival time was not reached years for HI and was also not reached for NH, and there was no overall survival difference favoring HI/NH (p = 0.43) On multivariate analysis, when adjusting for age, those who were > 80 years old and between 60-80 years old had worse OS compared to those < 60 years old with HR 33.5 (CI 95% 20.6 – 54.5) and 4.3 (CI 95% 2.7 – 6.9). Regarding stage, stage III/IV had worse OS than stage I/II with HR 1.9 (95% CI 1.1 – 3.4) vs HR 2.4 (95% CI 1.0 - 5.6). Conclusions: Overall HI were younger at the time of diagnosis without a significant difference in stage of diagnosis. Median survival was not reached in both NH and HI which reflects the good prognosis associated with NHLPL. Despite HI being having a younger median age of diagnosis than NH this did not correlate with improved OS in HI vs NH despite younger showing improved OS. Given there are little few other studies examining HI vs NH outcomes in NLPHL more research is needed to evaluate possible confounders skewing these results.