Racial differences in presentation and management of follicular non-Hodgkin lymphoma in the United States: Report from the National LymphoCare Study

BACKGROUND: Racial differences in follicular lymphoma (FL) in the United States have not been investigated. METHODS: The National LymphoCare Study is a multicenter, longitudinal, observational cohort study collecting data on treatment patterns and outcomes for patients with newly diagnosed FL in the United States between 2004 and 2007 without any predefined, study-specific intervention. The authors investigated differences between white (W) patients, African American (AA) patients, and Hispanic (H) patients. RESULTS: Among 2744 enrolled patients, there were 95 (3%) AA patients, 125 (5%) H patients, and 2476 (90%) W patients. Compared with W patients, more AA and H patients were diagnosed at age <45 years (P <.0001). H patients more commonly were diagnosed with grade 3 FL compared with AA and W patients (29%, 13%, and 18%, respectively; P =.019) and more commonly received rituximab plus chemotherapy as initial therapy compared with W patients (66% vs 50%; P =.036), while AA patients less commonly received anthracyclines (49% vs 64% in W patients; P =.027). H and AA patients who received rituximab plus chemotherapy were less likely than W patients to receive maintenance rituximab (27% vs 31% vs 40%, respectively; P =.031). At a median follow-up of 52 months, progression-free survival was similar between AA and W patients but was longer in H patients, and there was no difference in overall survival. CONCLUSIONS: In the largest prospective cohort to date of AA and H patients with FL in the United States, AA and H patients were younger at presentation. Although racial differences in treatment patterns for FL were noted, additional follow-up is needed to determine the impact of these differences on survival.