Treatment at Academic Treatment Centers Appears to Yield Longer Survival in Mantle Cell Lymphoma

A higher overall survival (OS) was observed among patients with mantle cell lymphoma (MCL) who were treated at higher-volume academic facilities compared with those treated at non-academic, lower volume facilities, according to a poster presentation from the 2021 American Society of Hematology Annual Meeting.

Investigators reported that the median OS for patients treated in academic centers was 7.5 years (95% CI, 50.2-55.8) compared with 4.3 years (95% CI, 67.1-76.3) in non-academic centers. For centers that treated between 1 to 3 individuals with MCL each year, patients had a median OS of 4.1 years (95% CI, 50.2-55.8). Moreover, facilities that treated 4 to 5 individuals per year reported that patients had a median OS of 5.1 years (95% CI, 67.1-76.3). Facilities that treated more than 6 individuals annually reported that patients with MCL had a median OS of 9 years (95% CI, 82.8-91.4).

A total of 22,751 patients with MCL were included in the study. Patients were stratified based on the average number of new patients with MCL who were treated at their facility yearly, which included 10,948 in tercile 1 (T1; 1 to 3 patients), 4637 in tercile 2 (T2; 4 to 5 patients), and 7166 in tercile 3 (T3; 6 patients or more). Patients had a similar median age of 70, 68, and 64 across the T1, T2, and T3 cohorts, respectively. The majority of patients were male across all groups, with 10,140, 4321, and 6637 being Caucasian in groups T1, T2, and T3, respectively.

Additionally, 2774 patients in T1, 1231 in T2, and 1765 in T3 earned between $48,000 and $62,999 per year. Moreover, 3388 patients in T1, 1436 in T2, and 2618 in T3 earned an income of $63,000 of higher.

A total of 1746 academic facilities and 9098 non-academic facilities were included in T1, 1927 and 2669 were included in T2, and 5811 and 1774 were included in T3, respectively. At present, a total of 2774 patients had B-symptoms at diagnosis in T1, 1206 had symptoms in T2, and 1774 had symptoms in T3. The majority of patients had stage IV disease, including 6215 patients in T1, 2941 in T2, and 5173 in T3. The remaining patients had stage III disease, including 1615 in T1, 621 in T2, and 814 in T3.

“Additional research is needed to fully understand the mechanisms behind these differences,” lead investigator Xavier Andrade-Gonzalez, MD, a hematology/oncology specialist at the Mayo Clinic, concluded. 

Reference

Andrade-Gonzalez X, Kommalpati A, Bock A, et al. Influence of treatment facility type and annual patient volume on overall survival in patients with mantle cell lymphoma: a national cancer database analysis. Blood. 2021; 138(suppl1):1348. doi:10.1182/blood-2021-151888