Outcome of Diffuse Large B-Cell Lymphoma in the United States Has Improved Over Time but Racial Disparities Remain: Review of SEER Data

Background: Diffuse large B-cell non-Hodgkin lymphoma (DLBCL) outcome in the United States has not been reported outside the context of clinical trials. Patients and Methods: We reviewed the Surveillance, Epidemiology,;and End Results (SEER) registry and compared survival trends among DLBCL patients from 1973 to 2004. Results: We identified 59,728 patients (mean age, 63 years; 54.4% men, 86.7% white) and had staging information for 57%, including 30% early-stage (I/II) and 27% advanced-stage (III/IV). Median overall survival (OS) from 1973 to 1979, 1980 to 1989,1990 to 1999, and 2000 to 2004 was 15, 18, 20, and 47 months, respectively (P < .005). For the period from 2000 to 2004, 4-year OS was 46%. Outcome was better in white patients than in black (47 months versus 29 months) (P=.001). Median OS for patients younger than 60 years old was not reached versus 23 months for patients older than 60 years. Conclusion: The outcome of DLBCL in the United States has improved significantly in the era of monoclonal antibodies; however, racial disparities remain.