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Abstract Nodular lymphocyte-predominant Hodgkin's lymphoma 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. This study aimed to compare the patient characteristics and outcomes of NLPHL patients treated 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). 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). Overall, 38% of patients presented at a late stage (stage III-IV) and was not different based on site of care (11 at PH vs 9 at SCCC; p=0.37). 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), 6 recurrences and 5 transformations were noted. Overall median survival was 62 months (IQR 21.5-84.5). Despite health inequities that typically impact safety-net patients, we did not observe differences in treatment patterns or outcomes of Nodular lymphocyte-predominant Hodgkin Lymphoma between patients treated at PH compared to SCCC.
Froessl et al. (Thu,) studied this question.