Dissecting racial, socioeconomic, and treatment disparities in peripheral T-cell lymphoma: A comprehensive Surveillance, Epidemiology, and End Results–based retrospective analysis.

Abstract

e19086 Background: Peripheral T-cell lymphomas (PTCLs) are aggressive and heterogeneous lymphomas with poor outcomes. The aim of this study was to evaluate potential survival disparities associated with race, socioeconomic status (SES), and treatment modalities in patients diagnosed with PTCLs using a large US population database. Methods: A retrospective cohort analysis was conducted using the SEER-17 database. Patients diagnosed with PTCL between 2000 and 2021 were included (n = 20,800). Patients diagnosed on autopsy or through death certificates, patients with incomplete follow-up data and patients with cutaneous T-cell lymphoma/mycosis fungoides were excluded. Patient demographics, treatment modalities, and survival data were analyzed. Descriptive statistics summarized the population. Survival was evaluated using Kaplan-Meier analysis and Cox proportional hazard modeling, stratified by race, SES, and treatment type. All analyses were undertaken on SPSS. Results: Among 20,800 patients, 58.6% were male, and 64.2% were Caucasian. Of the cohort, 15.5% received radiation therapy, and 53% received chemotherapy. Median overall survival (OS) for all patients was 54 months (95% CI: 50.7–57.3). Median OS varied significantly by race: 61 months for Caucasians, 33 months for African Americans, 56 months for Hispanics, 45 months for American Indians/Alaskan Natives, and 34 months for Asian Pacific Islanders (p < 0.001). SES also influenced outcomes, with median OS of 45 months for patients with household income < $50k, 65 months for $50–75k, and 78 months for > $75k (p < 0.001). Radiation therapy was associated with significantly improved survival (HR: 0.605; p < 0.001), whereas male sex (HR: 1.143; p < 0.001) and African American race (HR: 1.143; p < 0.001) were linked to worse survival. Conclusions: This study highlights significant disparities in PTCLs outcomes based on race, socioeconomic status, and treatment modalities. The data suggests that issues with social determinant of health that can impair access to high quality oncologic care could be critical to improve outcomes in PTCL patients, especially among minorities. Radiation therapy emerged as a key factor in improving survival, signifying the importance of equitable access to advanced treatment options. Multivariable Cox regression model for OS. Variable HR 95% CI (Lower) 95% CI (Upper) p-value Male sex 1.143 1.101 1.186 <0.001 Radiation 0.605 0.572 0.638 <0.001 Chemotherapy 1.146 1.105 1.189 <0.001 Income $50,000–75,000* 0.892 0.857 0.928 <0.001 Income >$75,000* 0.840 0.797 0.886 <0.001 African Americans** 1.143 1.084 1.206 <0.001 Hispanic** 0.983 0.928 1.041 0.550 American Indian / Alaskan Native** 1.037 0.818 1.315 0.763 Asian Pacific Islander** 1.147 1.071 1.228 <0.001 *Reference: <$50,000. **Reference: Caucasians.