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种族和民族对退伍军人健康管理局(VHA)内弥漫性大 B 细胞淋巴瘤结局的影响。

The impact of race and ethnicity on diffuse large B-cell lymphoma outcomes within the veterans health administration (VHA).

机构信息

University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.

South Texas Veterans Health Care System, San Antonio, TX, USA.

出版信息

Leuk Lymphoma. 2024 Aug;65(8):1090-1099. doi: 10.1080/10428194.2024.2338856. Epub 2024 Apr 15.

Abstract

We performed a retrospective chart review of 6266 randomly selected DLBCL patients treated in the VHA nationwide between 1/1/2011 and 12/31/2021. The 3178 patients who met inclusion criteria were predominantly male (97%) and white (75%). Median age of diagnosis for Black patients was 63 years vs 69 years for the entire cohort ( < 0.001). However, patients in each race/ethnicity subgroup presented with similar rates of stage I/II and III/IV disease, IPI score, cell of origin and HIT status. Outcomes analysis revealed similar treatment, response rates, median overall survival, and 1-, 3-, and 5-year survival across all subgroups. Hispanic patients had a 21% lower risk of death (HR = 0.79) than white patients, and Black patients had no significant difference in survival (HR = 0.98). This large retrospective study shows that when standard of care therapy is given within an equal access system, short-term treatment and survival outcomes are the same for all races.

摘要

我们对 2011 年 1 月 1 日至 2021 年 12 月 31 日期间在全美退伍军人事务部(VHA)接受治疗的 6266 名随机选择的弥漫性大 B 细胞淋巴瘤(DLBCL)患者进行了回顾性图表审查。符合纳入标准的 3178 名患者主要为男性(97%)和白人(75%)。黑人患者的诊断中位年龄为 63 岁,而整个队列的诊断中位年龄为 69 岁(<0.001)。然而,每个种族/族裔亚组的患者均具有相似的 I 期/II 期和 III 期/IV 期疾病、国际预后指数(IPI)评分、细胞起源和 HIT 状态发生率。结果分析显示,所有亚组的治疗、缓解率、中位总生存期以及 1、3 和 5 年生存率均相似。与白人患者相比,西班牙裔患者的死亡风险降低了 21%(HR=0.79),而黑人患者的生存率无显著差异(HR=0.98)。这项大型回顾性研究表明,当在公平获得医疗系统内给予标准治疗时,所有种族的短期治疗和生存结果均相同。

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