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. 2013 Feb;54(2):268-76.
doi: 10.3109/10428194.2012.708751.

Examining Racial Differences in Diffuse Large B-cell Lymphoma Presentation and Survival

Free PMC article

Examining Racial Differences in Diffuse Large B-cell Lymphoma Presentation and Survival

Christopher R Flowers et al. Leuk Lymphoma. .
Free PMC article


We performed a retrospective cohort analysis of 701 (533 white and 144 black) patients with diffuse large B-cell lymphoma (DLBCL) treated at two referral centers in southern United States between 1981 and 2010. Median age of diagnosis for blacks was 50 years vs. 57 years for whites (p < 0.001). A greater percentage of blacks presented with elevated lactate dehydrogenase levels, B-symptoms and performance status ≥ 2. More whites (8%) than blacks (3%) had a positive family history of lymphoma (p = 0.048). There were no racial differences in the use of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone; 52% black vs. 47% white, p = 0.73). While black race predicted worse survival among patients treated with CHOP (hazard ratio [HR] 1.8, p < 0.001), treatment with R-CHOP was associated with improved survival irrespective of race (HR 0.61, p = 0.01). Future studies should examine biological differences that may underlie the observed racial differences in presentation and outcome.

Conflict of interest statement

Declaration of Interest: Flowers: Consultancy (paid) - Spectrum, Celgene, Optum Rx, Seattle Genetics; Consultancy (unpaid) – Genentech/Biogen-Idec/Roche, Millenium/Takeda; Research Funding – Spectrum, Novartis, Millenium/Takeda, Gilead; Payment for development of educational presentations – Clinical Care Options, Educational Concepts.

None of the other authors have any conflict of interest to disclose


Figure 1
Figure 1. Selection of study cohort
This figure provides an overview of the study cohort with reasons for inclusion/exclusion through the selection process.
Figure 2
Figure 2. Trends in use of CHOP and R-CHOP as first line of treatment of DLBCL
Plots the percentage of white and black patients with DLBCL that were treated with CHOP and R-CHOP across the years.
Figure 3
Figure 3. Kaplan Meier Survival Curves of DLBCL Patients
(A) Survival curves of patients receiving CHOP by race. (B) Survival curves of patients receiving R-CHOP by race.

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