{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T03:11:34Z","timestamp":1785553894034,"version":"3.56.0"},"reference-count":32,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"32","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2019,11,10]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> Population-based studies of children and adolescents with Hodgkin lymphoma (HL) report a survival disadvantage in nonwhite\u2014non-Hispanic black (NHB) and Hispanic\u2014patients. Whether disparities persist after adjustment for clinical and treatment-related variables is unknown. We examined survival by race\/ethnicity in children receiving risk-based, response-adapted, combined-modality therapy for HL in contemporary Children\u2019s Oncology Group trials. <\/jats:p><\/jats:sec><jats:sec><jats:title>PATIENTS AND METHODS<\/jats:title><jats:p> This pooled analysis used individual-level data from 1,605 patients (younger than age 1 to 21 years) enrolled in phase III trials for low-risk (AHOD0431), intermediate-risk (AHOD0031), and high-risk (AHOD0831) HL from 2002 to 2012. Event-free survival (EFS) and overall survival (OS) were compared between non-Hispanic white (NHW) and nonwhite patients. Cox proportional hazards for survival were estimated for both de novo and relapsed HL, adjusting for demographics, disease characteristics, and therapy. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> At median follow up of 6.9 years, cumulative incidence of relapse was 17%. Unadjusted 5-year EFS and OS were 83% (SE, 1.2%) and 97% (SE, &lt; 1%), respectively. Neither differed by race\/ethnicity. In multivariable analyses for OS, nonwhite patients had a 1.88\u00d7 higher hazard of death (95% CI, 1.1 to 3.3). Five-year postrelapse survival probabilities by race were as follows: NHW, 90%; NHB, 66%; and Hispanic, 80% ( P &lt; .01). Compared with NHW, Hispanic and NHB children had 2.7-fold (95% CI, 1.2 to 6.2) and 3.5-fold (95% CI, 1.5 to 8.2) higher hazard of postrelapse mortality, respectively. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> In patients who were treated for de novo HL in contemporary Children\u2019s Oncology Group trials, EFS did not differ by race\/ethnicity; however, adjusted OS was significantly worse in nonwhite patients, a finding driven by increased postrelapse mortality in this population. Additional studies examining treatment and survival disparities after relapse are warranted. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.19.00812","type":"journal-article","created":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T19:55:13Z","timestamp":1569009313000},"page":"3009-3017","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":52,"title":["Survival by Race and Ethnicity in Pediatric and Adolescent Patients With Hodgkin Lymphoma: A Children\u2019s Oncology Group Study"],"prefix":"10.1200","volume":"37","author":[{"given":"Justine M.","family":"Kahn","sequence":"first","affiliation":[{"name":"Columbia University Irving Medical Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara M.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Roswell Park Comprehensive Cancer Center, Buffalo, 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