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Survival by Race and Ethnicity in Children and Adolescents/Young Adults With Relapsed/Refractory Hodgkin Lymphoma: A Pooled Analysis of Children's Oncology Group Trials.

Mallorie B Heneghan·Lindsay A Renfro·Yue Wu·Katia M Crisler·Erin Marcotte·Tanya Trippett·Terzah Horton·Bradford S Hoppe·Frank G Keller·Chris Forlenza·Cindy Schwartz·Kara M Kelly·Peter D Cole·Sharon M Castellino·Justine M Kahn
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Abstract

PURPOSE: Despite 5-year survival rates of over 90% among children and adolescents/young adults (CAYAs) with classic Hodgkin lymphoma (cHL), 15%-20% relapse after frontline therapy. Prior analysis of frontline Children's Oncology Group (COG) clinical trials demonstrated that, despite similar rates of relapse, non-Hispanic Black (NHB) and Hispanic (vs. non-Hispanic White [NHW]) patients experienced higher post-relapse mortality. It is unknown whether post-relapse disparities persist when second-line treatment is delivered in a cooperative group trial setting. We examined overall survival (OS) by race and ethnicity in CAYAs enrolled in COG trials for relapsed/refractory (r/r) cHL. METHODS: A pooled analysis of individual-level data from CAYAs (≤ 29 years) receiving therapy for r/r cHL on COG clinical trials (2001-2016) was conducted. The Kaplan-Meier method estimated 3-year OS by racial and ethnic groups. Cox regression models examined associations of race and ethnicity and OS, adjusted for age, insurance, first versus ≥2 relapse, and time from initial diagnosis to relapse trial enrollment. RESULTS: Among 175 CAYAs treated on COG trials for r/r cHL (5.7% Asian or Pacific Islander, 14.9% Hispanic, 14.3% NHB, 61.7% NHW, 3.4% other), at median follow-up of 4.9 years, 3-year OS was 82.1% (95% confidence interval [CI], 75.3%-87.1%) and did not differ by race and ethnicity (p = 0.36). In multivariable analyses, shorter time from diagnosis to relapse trial enrollment (p = 0.01) and ≥2 relapses (vs. first, p = 0.004) conferred worse OS, with no significant effect of race and ethnicity (p = 0.43). CONCLUSION: Post-relapse survival did not differ by race and ethnicity among CAYAs enrolled in COG trials for r/r cHL, suggesting access to clinical trials may mitigate OS disparities.

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HumansHodgkin DiseaseAdolescentChildFemaleYoung AdultMaleSurvival RateAdultNeoplasm Recurrence, LocalChild, PreschoolEthnicityPrognosisFollow-Up StudiesHispanic or LatinoAntineoplastic Combined Chemotherapy ProtocolsWhiteHodgkin lymphomaadolescent and young adult oncologyclinical trial enrollmentrace/ethnicitysurvival disparitiesJournal Article

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Mallorie B Heneghan, Lindsay A Renfro, Yue Wu, Katia M Crisler, Erin Marcotte, Tanya Trippett, Terzah Horton, Bradford S Hoppe, Frank G Keller, Chris Forlenza, Cindy Schwartz, Kara M Kelly, Peter D Cole, Sharon M Castellino, Justine M Kahn. 2026-07-24. Survival by Race and Ethnicity in Children and Adolescents/Young Adults With Relapsed/Refractory Hodgkin Lymphoma: A Pooled Analysis of Children's Oncology Group Trials.. https://doi.org/10.1002/1545-5017.70522

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Journal Article resourceAdolescent subjectAdult subjectAntineoplastic Combined Chemotherapy Protocols subjectChild subjectChild, Preschool subjectEthnicity subjectFemale subjectFollow-Up Studies subjectHispanic or Latino subjectHumans subjectJournal Article subjectMale subjectPrognosis subject

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