Clinical characteristics, response to therapy, and survival of African American patients diagnosed with chronic lymphocytic leukemia. Issue 17 (8th July 2013)

• Record Type: Journal Article
• Authors: Falchi, Lorenzo; Keating, Michael J.; Wang, Xuemei; Coombs, Catherine C.; Lanasa, Mark C.; Strom, Sara; Wierda, William G.; Ferrajoli, Alessandra
• Is Part Of: Cancer. Volume 119:Issue 17(2013)
• Page Start: 3177
• Page End: 3185
• Publication Date: 2013-07-08
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.28030
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr28030-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>Little is known regarding racial disparities in characteristics and outcomes among patients with chronic lymphocytic leukemia (CLL).</p> </sec> <sec id="cncr28030-sec-0002" sec-type="section"> <title>METHODS</title> <p>The characteristics and outcomes of untreated African American (AA) patients with CLL (n = 84) were analyzed and compared with a reference nonblack (NB) patient population (n = 1571).</p> </sec> <sec id="cncr28030-sec-0003" sec-type="section"> <title>RESULTS</title> <p>At the time of presentation, AA patients had lower median hemoglobin levels (12.9 g/dL vs 13.7 g/dL), higher β2 microglobulin levels (2.7 mg/dL vs 2.4 mg/dL), greater frequency of constitutional symptoms (27% vs 10%), unmutated immunoglobulin heavy‐chain variable region (<italic>IGHV</italic>) mutation status (65% vs 47%), ζ‐chain–associated protein kinase 70 (ZAP70) expression (58% vs 32%), and deletion of chromosome 17p or chromosome 11q (28% vs 17%; <italic>P</italic> ≤ 02 for each comparison). Fifty‐one percent of AA patients and 39% of NB patients required first‐line therapy and 91% and 88%, respectively, received chemoimmunotherapy. Overall response rates to treatment were 85% for AA patients and 94% for NB patients (<italic>P</italic> = .06); and the complete response rates were 56% and 58%, respectively (<italic>P</italic> = .87). The median survival of AA patients was shorter compared with that of NB patients (event‐free survival: 36 months vs 61 months; <italic>P</italic> = .007; overall survival: 152 months vs not reached; <italic>P</italic> = .0001). AA race was an independent predictor of shorter event‐free and overall survival in multivariable regression models.</p> </sec> <sec id="cncr28030-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>The current results indicated that AA patients with CLL have more unfavorable prognostic characteristics and shorter survival compared with their NB counterparts. <bold><italic>Cancer</italic> 2013;119:3177–3185</bold>. © 2013 American Cancer Society.</p> </sec> </abstract>