Survival after diffuse large B‐cell lymphoma among children, adolescents, and young adults in California, 2001–2014: A population‐based study. Issue 4 (4th December 2018)

• Record Type: Journal Article
• Authors: Abrahão, R.; Ribeiro, R.C.; Lichtensztajn, D.Y.; Rosenberg, A.S.; Keegan, T.H.M.
• Is Part Of: Pediatric blood & cancer. Volume 66:Issue 4(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-12-04
• Subjects: AYA -- children -- DLBCL -- population‐based study -- rituximab -- survival; Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.27559
• Languages: English
• ISSNs: 1545-5009

Abstract

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.