Incidence patterns and outcomes for hodgkin lymphoma patients in the United States

Abstract

Hodgkin lymphoma (HL) demonstrates heterogenous histologic findings, clinical presentation, and outcomes. Using the United States Surveillance, Epidemiology, and End Results (SEER) data we examined relationships between patient characteristics, clinical features at diagnosis, and survival in HL patients. From 2000 to 2007, 16,710 cases were recorded in 17 SEER registries. Blacks and Asians had low incidence (black/white incidence rate ratio (IRR) 0.86, P < .01; Asian/white IRR 0.43, P < .01). The bimodal pattern of incidence was less prominent for black males. Asians and Blacks presented at a mean age of 38 years compared to 42 years for Whites (P < .001). Race was a predictor for survival with HR of 1.19 (95% CI 1.11-1.28) for Blacks. Age was the most important predictor of survival (HR for patients ≥45 years 5.08, 95% CI 4.86-5.31). These current patterns for presentation and outcomes of HL help to delineate key populations in order to explore risk factors for HL and strategies to improve treatment outcomes.

Figure 1

Selection of study cohort. These figures provide an overview of the study cohort with reasons for inclusion/exclusion through the selection process. (a) Selection of the cases included in the incidence analyses. (b) Selection of the cases included in the survival analyses.

Figure 2

Age distribution of HL by race. (a) Plots are the race- and gender-specific age-adjusted incidence rates of CHL by age at diagnosis. (b) Plots are the race- and gender-specific age-adjusted incidence rates of NLP HL by age at diagnosis. (c) Plots are the age distribution of CHL patients. Horizontal axis represents the grouping of age at diagnosis. Vertical axis represents the proportion of patients in each age group for that particular race (White, Black, and Asian/Pacific Islander). (d) Plots are the age distribution of NLP HL patients. Horizontal axis represents the grouping of age at diagnosis. Vertical axis represents the proportion of patients in each age group for that particular race (White, Black, and Asian/Pacific Islander).

Figure 3

Kaplan-Meier Survival Curves of HL Patients. (a) Survival curves by race. (b) Survival curves by age at diagnosis (<45 versus ≥45 years) and stage (Stage I-IIA versus Stage IIB-IV). (c) Survival curves by era of diagnosis. (d) Survival curves for CHL and NLP HL.