Over the last 2 decades, treatment for chronic lymphocytic leukemia (CLL) has evolved substantially. For a study, researchers sought to look at data from the Surveillance, Epidemiology, and End Results (SEER) program to see how race and socioeconomic status (SES) affect CLL patient survival. From 2006 to 2018, CLL cases were reported to 18 SEER Program registries. Pt characteristics like age at diagnosis (dx), sex, year of diagnosis (yr), race, and SES as determined by rural/urban census tract residence (RUCA) and neighborhood (as represented by the Yost Index, a composite measure of 7 variables assessing different aspects of a census tract’s SES) were collected and analyzed. The adjusted odds of survival were calculated using multivariable Cox regression (MVA). About 2 databases were used: 1 that contained data up to 2018 and another that contained SES data but only had data up to 2016. Without SES data, 46,605 instances were detected from 2009 to 2018. From 2009 to 2018, there was an equitable distribution of individuals diagnosed with CLL, with a median age of 70 years and a male-to-female ratio of 60%. There were 89.9% white cases, 7.3% black cases, 2.4% Asian/Pacific islander cases, and 0.3% American Indian/Alaska Native cases. The median 3-, 5-, and 10-year overall survival (OS) rates were 79.5%, 69.5%, and 48.8%, respectively, after a median follow-up of 47 months. MVA revealed that the Black race (HR 1.5, 95% CI 1.4–1.6) was the strongest independent predictive indicator for poorer OS after adjusting for yr of diagnosis, implying that race significantly influenced OS in the current period of therapy. From 2006 to 2016, 47,867 cases of CLL were studied using the connected RUCA and Yost tertiles for SES. The median age, sex, and race distribution were comparable to the previous analysis. MVA identified American Indian/Alaska Native and Black races as independent prognosis variables for the poorer OS.
In contrast, Yost groups 2 and 3 indicated more excellent socioeconomic status and were identified as significant independent prognostic variables for better OS. After correcting for SES, race remained an independent predictor of poorer OS in this study. In CLL, the black race and low SES were associated with a poor prognosis. More research was needed to understand whether this was attributable to illness biology, access to therapy, quality of care, or social determinants of health.
