A two statewide population based study evaluating ethnic patterns, differences in treatment and survival between Hispanics and non-Hispanics with peripheral T cell lymphoma.
Authors: Rosas Daniel , Warnecke Brian , Wehbe Alexandra , Liu Qianqian , Michalek Joel , Diaz Duque Adolfo Enrique 
Published: June 2022

e19567

Background: Peripheral T-cell lymphomas (PCTLs) are an aggressive group of lymphomas that comprise less than 15% of all non-Hodgkin lymphomas in adults. There is limited literature regarding differences in outcomes for Hispanics (H). Some studies indicate worse outcomes in H compared to non-Hispanics (NH), whereas others have shown comparable outcomes. The purpose of this study is to evaluate demographics, treatment patterns and survival outcomes of PCTLs among H vs. NH in Texas (TX) and Florida (FL). Methods: This is a retrospective analysis of patients with PTCLs from the Texas Cancer Registry (TCR) and the Florida Cancer Data System (FCDS), from 2006-2017. Inclusion criteria was histopathologic proven PTCLs. Patients were divided into H and NH for comparison. Standard demographic, socioeconomic, clinical, and survival variables were reviewed. All statistical testing was determined using Fisher’s Exact test, Pearson’s Chi-square test, T-test or Wilcoxon test, as appropriate. Survival time was measured using the day of diagnosis to last date of follow up or death. Survival distributions were calculated based on Kaplan-Meier curves. Results: We identified 3358 patients. In TX 51% were H, and 49% were NH. In FL 27% were H, and 73% were NH. Median age at diagnosis of H was 70-79 years (y) (19%) and NH was 60-69 (23%) in TX (p < 0.001). Median age at diagnosis of H was 50-59 y (26%) and NH was 70-7 y (26%) in FL (p < 0.001). Most frequent poverty index was 20-100% for H vs 10-19.9% for NH (p < 0.001) in TX and 10-19% for both H and NH (p < 0.001) in FL. Government-sponsored insurance (GSI) was 40% in H vs 46% in NH (p < 0.001) in TX and 35% vs 31% in NH (p < 0.001) in FL. Most common stage at diagnosis for both groups was III/IV with 50% in H vs 49% in NH (p = 0.01) in TX; and stage I with 53% H vs 42% in NH (p = 0.05) in FL. Median overall survival (MOS) in TX for H was 1.4 years vs 1.5 in NH; survival probability (SP) for H vs NH at 2 y was 0.42 vs 0.44, at 5 y 0.32 vs 0.31, and at 10 y 0.21 vs 0.14 with no statistically significant difference in overall survival (OS). MOS in FL for H was 1.9 y vs 1.8 y in NH; SP for H vs NH at 2 y was 0.48 vs 0.47, at 5 y 0.36 vs 0.33, and at 10 y 0.24 vs 0.20 with no statistically significant difference in OS. Conclusions: Amongst the population of TX and FL, H with PTCLs have similar outcomes when compared to NH. There were no statistically significant differences in MOS or SP at 2, 5, and 10 y among the H cohorts. There were statistically significant differences between H and NH patients in median age of diagnosis, poverty index, and insurance status at diagnosis. These disparities were observed in both states and may be a direct reflection of the significantly higher rates of poverty and lack of insurance among H. Within the context of healthcare equality, we ascertained similar outcomes amongst groups, which agrees with previous reports claiming homogeneity of medical care.