The impact of race, ethnicity, age and sex on clinical outcome in chronic lymphocytic leukemia: a comprehensive Surveillance, Epidemiology, and End Results analysis in the modern era

Abstract

To analyze racial, ethnic, sex and age disparities in chronic lymphocytic leukemia (CLL), we examined population-based overall survival (OS) data from Surveillance, Epidemiology, and End Results (SEER)-13 (1992-2009) across various races/ethnicities over two consecutive 9-year periods: era 1 (1992-2000) and era 2 (2001-2009). We analyzed 28 590 patients (whites: 24 438, blacks: 1954, Hispanics: 1389 and Asians/Pacific Islanders [A/PI]: 809). A higher proportion of whites were aged > 80 years (22% vs. 17% [Hispanics], 16% [blacks], 16% [A/PI]; p < 0.001). Higher socioeconomic status (SES) was also identified for A/PI and whites compared with blacks and Hispanics (p < 0.001). OS for all patients improved at 5 years (66% vs. 60%, p < 0.0001) and was significant in all races/ethnicities except A/PI. Patients of higher SES had better outcomes than others independent of era, but both SES classes experienced relative improvement in their OS across eras. The OS of patients with CLL has improved in the modern era but racial/ethnic, gender and SES differences persist, warranting further investigation.

Keywords: Chronic lymphocytic leukemia; age disparity; ethnic disparity; gender disparity; racial disparity; survival.