Abstract 4839: Ethnicity dictates survival benefit in Hispanics diagnosed with diffuse large B-Cell lymphoma survival: A national cancer database analysis
Authors: Velez-Mejia Carolina , Velez Esteban Toro , Rosas Daniel , Liu Qianqian , Michalek Joel E. , Duque Enrique Diaz 
Published: March 2024

Abstract
Background: Diffuse Large B-Cell Lymphoma (DLBCL) is the most common Non-Hodgkin lymphoma in the United States (US) but there is limited evidence showing ethnic disparities affecting overall survival (OS) (Blood10.1182/blood-2022-159201, Blood10.1182/blood-2021-151816). This is the largest nationwide cancer registry analysis evaluating ethnic differences for HI vs Non-Hispanics (NH) with DLBCL in the US.
Methods: Data were analyzed using the National Cancer Database from 2004-2019. Sociodemographic characteristics were compared between ethnic groups. Kaplan-Meier and Cox regression analyses were used to compare OS between HI and NH. Multivariate analysis and propensity score matching were performed with adjustment for age, stage, comorbidity score, and insurance status, type of facility, and great circle distance
Results: 239,391 patients (HI n=18,290, NH n=221,101) were diagnosed with DLBCL. Male sex predominated for both and the majority of patients were Whites. HI were diagnosed at a median age of 62 years (y) vs 68 y for NH [p&lt;0.001]. For HI and NH, most of the patients were diagnosed from 2016-2019.
For both groups, the majority of patients had a Charlson-Deyo Score of 0, stage IV at diagnosis and unknown HIV status. The primary payer at diagnosis was government sponsored for HI and NH. In HI the median income based on the Median Income Quartile for 2000 corresponded to the highest level of &gt;$46,000 and from 2008-2012 it was similarly distributed. For NH, for both time periods the majority of the patient were in the highest bracket. Most patients in the HI and NH were located in metropolitan area and were more likely to be treated at a comprehensive cancer center with a great circle distance (miles) of 7.3 for HI and 9.7 for NH.
The median survival for HI was 11 y vs 6.8 y for NH. The survival probability at 2, 5 and 10 y for HI corresponded to 69%, 61% and 52%, while for NH it was 66%, 55% and 41%, respectively. The OS probability at 10 y was statistically significant favoring HI [p&lt;0.0001]. Independently, on multivariate analysis, not insured status was associated with worse OS (HR 1.2, CI 1.13-1.28, [p&lt;0.01]) and private insurance type was associated with better OS (HR 0.81, CI 0.77-0.84, [p&lt;0.01])
Conclusion: This nationwide cancer registry study identified better OS in HI diagnosed with DLBCL in the US. Both cohorts had similar sociodemographic and clinical results; however, HI were diagnosed at younger age. This finding may not only help to explain a unique trait towards development of cancer at an earlier age, but also an enhanced response to therapy. Regarding median income there wasn’t a tendency noted for HI, which support the unique complex interactions in socioeconomic status. Further studies examining intrinsic biologic differences are needed to better understand improved OS for HI, which could also help the rational development of targeted therapies.
Citation Format: Carolina Velez-Mejia, Esteban Toro Velez, Daniel Rosas, Qianqian Liu, Joel E. Michalek, Enrique Diaz Duque. Ethnicity dictates survival benefit in Hispanics diagnosed with diffuse large B-Cell lymphoma survival: A national cancer database analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4839.