Abstract B127: Differences in all-cause mortality among patients with classical Hodgkin lymphoma

Abstract Background: Patients with classical Hodgkin lymphoma (CHL) have high overall survival, but the racial and ethnic variations in mortality remain unclear. This study aimed to comprehensively examine racial and ethnic differences in mortality for CHL patients across patient and tumor characteristics. Methods: Using the SEER 17 database linked to death data from the National Center for Health Statistics, we identified 28,029 adults (>20 yrs) diagnosed with first primary CHL between 2000-2020 who had received chemotherapy and/or immunotherapy, with follow-up through 2021. We estimated hazard ratios (HRs) for all-cause mortality using multivariable Cox proportional hazards models for Hispanic (all races, N=4,610), non-Hispanic American Indian/Alaska Native (AI/AN, N=81), non-Hispanic Asian American (Asian American, N=1,342), non-Hispanic Black (Black, N=2,981), non-Hispanic Native Hawaiian and Pacific Islander (NHPI, N=143) compared with non-Hispanic White (White, N=18,872) individuals. Models used attained age as the timescale and adjusted for sex, year of diagnosis, stage at diagnosis, time since diagnosis, and county-level income. We further investigated mortality differences among Asian ethnogeographic region, in comparison to White, including East (n=331), Southeast (n=421), South (n=350), and Other (n=240) Asian. We also estimated all-cause 10-year cumulative mortality (CM) by race and ethnicity. Results: Compared to White patients, NHPI (HR 1.71, 95% CI 1.18-2.48), AI/AN (HR 1.51, 95% CI 1.01-2.26), Black (HR 1.50, 95% CI 1.39-1.62), Hispanic (HR 1.32, 95% CI 1.23-1.41), and Asian American (HR 1.17, 95% CI 1.03-1.34) patients had significantly increased all-cause mortality. Hispanic and Black patients had persistently elevated mortality risks across all diagnosis periods, stages, and county-level household income categories. The greatest mortality risks were observed among AI/AN females or AI/AN diagnosed at stage I/II (HR range=2.38-2.86); Asian American diagnosed at ≥ 85 yrs (HR 2.26); and NHPI diagnosed between 2005-2009, at stage III/IV, or residing in middle-income counties (HR range=2.15-2.58), compared to White patients. Among Asian American patients, East and Southeast Asian had increased mortality compared to White patients (HR 1.27, 95% 1.02-1.58, and HR 1.39, 95% 1.12-1.73, respectively). By 10 yrs after diagnosis, the highest CM overall was observed among AI/AN patients (33.28%, 95% CI 21.07%-45.49%), followed by Black (26.08%, 95% CI 24.32%-27.84%), Hispanic (24.01%, 95% CI 22.56%-25.45%), White (21.02%, 95%CI 20.38%-21.66%), NHPI (19.41%, 95%CI 11.81%-27.01%), and Asian American (18.55%, 95%CI 16.17%-20.93%) patients. Conclusions: These results indicate significant racial and ethnic differences in mortality in CHL patients, which persisted across patient and tumor characteristics. Our findings highlight the need to better understand these disparities to inform quality cancer care for all patients and to address heterogeneity in cancer survival. Citation Format: Yuehan Wang, Lisa X. Lee, Jacqueline Chow, Jaimie Z. Shing, Lindsay M. Morton, Jacqueline H.J. Kim, Jacqueline B. Vo. {Title} [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B127.