Abstract
Background: This population-based study considered the influence of rituximab on the survival of children (0–19 years), adolescents, and young adults (AYAs, 20–39 years) with diffuse large B-cell lymphoma (DLBCL), including patients with human immunodeficiency virus (HIV) infection. Methods: Data on 642 children and AYAs diagnosed with DLBCL during 2001–2014 were obtained from the Greater Bay Area Cancer Registry in California. Facility-level reports provided treatment details. The Kaplan–Meier method estimated survival and Cox regression models examined the association between survival and rituximab use, adjusting for sociodemographic and clinical factors. Results: Rituximab use increased from 2001–2007 to 2008–2014 among children (from 32% to 48%), AYAs (from 68% to 84%), and HIV patients (from 57% to 67%). Five-year survival was higher among children (91%) than AYAs (82%). On multivariable analysis, the hazard of death was 44% lower among rituximab recipients, and higher among uninsured patients, those with HIV, and those with advanced stage at diagnosis. HIV patients who received rituximab were 60% less likely to die than nonrecipients. Conclusions: Our study suggests a benefit of rituximab on the treatment of AYAs and HIV patients with DLBCL. The worse survival observed among HIV-positive and uninsured patients is of concern and calls for further investigation. Careful consideration should be given on whether to recommend rituximab more often on the front-line treatment of children and HIV-positive patients with DLBCL.
| Original language | English (US) |
|---|---|
| Article number | e27559 |
| Journal | Pediatric Blood and Cancer |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
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Keywords
- AYA
- children
- DLBCL
- population-based study
- rituximab
- survival
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Hematology
- Oncology
Cite this
Survival after diffuse large B-cell lymphoma among children, adolescents, and young adults in California, 2001–2014 : A population-based study. / Abrahão, R.; Ribeiro, R. C.; Lichtensztajn, D. Y.; Rosenberg, A. S.; Keegan, Theresa H.
In: Pediatric Blood and Cancer, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Survival after diffuse large B-cell lymphoma among children, adolescents, and young adults in California, 2001–2014
T2 - A population-based study
AU - Abrahão, R.
AU - Ribeiro, R. C.
AU - Lichtensztajn, D. Y.
AU - Rosenberg, A. S.
AU - Keegan, Theresa H
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: This population-based study considered the influence of rituximab on the survival of children (0–19 years), adolescents, and young adults (AYAs, 20–39 years) with diffuse large B-cell lymphoma (DLBCL), including patients with human immunodeficiency virus (HIV) infection. Methods: Data on 642 children and AYAs diagnosed with DLBCL during 2001–2014 were obtained from the Greater Bay Area Cancer Registry in California. Facility-level reports provided treatment details. The Kaplan–Meier method estimated survival and Cox regression models examined the association between survival and rituximab use, adjusting for sociodemographic and clinical factors. Results: Rituximab use increased from 2001–2007 to 2008–2014 among children (from 32% to 48%), AYAs (from 68% to 84%), and HIV patients (from 57% to 67%). Five-year survival was higher among children (91%) than AYAs (82%). On multivariable analysis, the hazard of death was 44% lower among rituximab recipients, and higher among uninsured patients, those with HIV, and those with advanced stage at diagnosis. HIV patients who received rituximab were 60% less likely to die than nonrecipients. Conclusions: Our study suggests a benefit of rituximab on the treatment of AYAs and HIV patients with DLBCL. The worse survival observed among HIV-positive and uninsured patients is of concern and calls for further investigation. Careful consideration should be given on whether to recommend rituximab more often on the front-line treatment of children and HIV-positive patients with DLBCL.
AB - Background: This population-based study considered the influence of rituximab on the survival of children (0–19 years), adolescents, and young adults (AYAs, 20–39 years) with diffuse large B-cell lymphoma (DLBCL), including patients with human immunodeficiency virus (HIV) infection. Methods: Data on 642 children and AYAs diagnosed with DLBCL during 2001–2014 were obtained from the Greater Bay Area Cancer Registry in California. Facility-level reports provided treatment details. The Kaplan–Meier method estimated survival and Cox regression models examined the association between survival and rituximab use, adjusting for sociodemographic and clinical factors. Results: Rituximab use increased from 2001–2007 to 2008–2014 among children (from 32% to 48%), AYAs (from 68% to 84%), and HIV patients (from 57% to 67%). Five-year survival was higher among children (91%) than AYAs (82%). On multivariable analysis, the hazard of death was 44% lower among rituximab recipients, and higher among uninsured patients, those with HIV, and those with advanced stage at diagnosis. HIV patients who received rituximab were 60% less likely to die than nonrecipients. Conclusions: Our study suggests a benefit of rituximab on the treatment of AYAs and HIV patients with DLBCL. The worse survival observed among HIV-positive and uninsured patients is of concern and calls for further investigation. Careful consideration should be given on whether to recommend rituximab more often on the front-line treatment of children and HIV-positive patients with DLBCL.
KW - AYA
KW - children
KW - DLBCL
KW - population-based study
KW - rituximab
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85058028146&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85058028146&partnerID=8YFLogxK
U2 - 10.1002/pbc.27559
DO - 10.1002/pbc.27559
M3 - Article
C2 - 30511461
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
SN - 1545-5009
M1 - e27559
ER -