Patient Characteristics and Outcomes of Nodular Lymphocyte-Predominant Hodgkin's Lymphoma at a Safety-Net System Compared to an Academic Comprehensive Cancer Center.

Abstract

Introduction: Nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL) often follows an indolent course but carries a risk of late recurrence and transformation. Given its rarity, there is significant variability in the treatment patterns at various healthcare centers.

Methods: This retrospective chart review aimed to compare the patient characteristics and outcomes of NLPHL patients >18 years of age diagnosed between January 1st, 2007, and December 31st, 2022, at Parkland Health, the safety-net system for uninsured/underinsured patients in Dallas County, with patients treated at the neighboring NCI-designated Harold C. Simmons Comprehensive Cancer Center (SCCC).

Results: Our cohort included 53 adult patients (25 at PH vs. 28 at SCCC). PH patients were more likely to belong to racial/ethnic minority groups (black non-Hispanic 84% at PH vs. 32% at SCCC, Hispanic 16% at PH vs. 0% at SCCC, p < 0.01) and to be uninsured (60% at PH vs. 0% at SCCC, p < 0.01). Site of care (PH vs. SCCC) or race/ethnicity did not impact the treatment choice. At a median follow-up of 60 months (IQR 21-83), 3 deaths occurred, resulting in an overall 5-year restricted mean overall survival of 57 months. Overall survival and progression-free survival were not statistically different between the two sites of treatment.

Conclusion: Despite health inequities that typically impact safety-net patients, we did not observe differences in treatment patterns or outcomes of Nodular lymphocyte-predominant Hodgkin's lymphoma between patients treated at PH compared to SCCC.