Abstract 3818: Sociodemographic, access to care and survival outcomes for patients with mantle cell lymphoma: A national cancer database analysis with focus on Hispanics
Authors: Velez Esteban Toro , Velez-Mejia Carolina , Rosas Daniel , Liu Qianqian , Michalek Joel , Duque Adolfo Enrique Diaz 
Published: March 2024

Background: Mantle cell lymphoma (MCL), represents 3% of new cases of non-Hodgkin’s lymphomas.(PMID 29348844) MCL affects mainly males; factors like ethnicity, age at presentation can have prognostic implications. Currently, it isn’t clear if Hispanics (HI) have a survival difference compared to Non-Hispanics (NH).(PMID 31029647, PMID 25315847). This National Cancer Database (NCDB) analysis aims to clarify how sociodemographic factors affect presentation and survival in HI vs NH patients with MCL.

Methods: Data were analyzed on MCL patients in the United States reported to the NCDB 2004-2019. Demographic and treatment characteristics were compared between ethnic groups. Kaplan-Meier and Cox regression analyses were used to compare overall survival (OS). Multivariate analysis and propensity score matching was performed.

Results: Of 32515 of MCL patients, 1729 were HI, and 29309 NH. Male gender and identification as white predominated for both. HI were diagnosed at a younger median age of 65 years (y) vs 68 y for NH, p&lt;0.001. Most patients were diagnosed between years 2016-2019. Stage IV predominated for HI and NH, p&lt;0.001. As to Charlson-Deyo Score ≥2, HI had 6% vs NH 8%. Government sponsored was the most prevalent primary payer, HI (54%) and NH (60%). HI had a higher percentage of unknown/uninsured, 13% vs 4% for NH, p&lt;0.001. In relation to census median income (2008-2012), the most prevalent bracket for HI and for NH was &gt;$63,000, 29% and 37% respectively. When analyzing median income of less than $38,000, HI were 22% vs 13% for NH, p&lt;0.001. For median distance in miles (mi) between the patient’s residence and the hospital that reported the case (Great circle distance), HI lived at a median of 8.2mi, vs NH at median of 11.3mi. Most patients were treated at Academic/Research programs, 50% for HI and 39% for NH, p&lt;0.001. On survival analysis, the survival probability at 2, 5 and 10 for HI was 74%, 57%, 44%, vs for NH was 72%, 54%, 36%, respectively. The median survival (MS) was 7.0 years for HI, vs 5.8 years for NH, with a statically significant difference in OS favoring HI, p=0.00015. On multivariate analysis, not insured status was independently associated with worse OS (HR 1.29, CI 1.08-1.55, p=0,01). The propensity matched analysis showed significant MS difference between HI vs NH (5.8 y vs. 5.6 y).

Conclusion: In this analysis, MCL is a malignancy that presents at advanced stages, affecting mainly the elderly white males. HI compared to NH have a statically significant benefit in OS, which might be driven by a younger population with less comorbidities. Despite HI having limited access to insurance and lower income; sociodemographic differences don’t seem to be barriers for HI to access care at academic centers. Newer studies should focus on understanding what genetic and intrinsic disease factors cause HI to have an earlier presentation and a survival advantage over NH.

Citation Format: Esteban Toro Velez, Carolina Velez-Mejia, Daniel Rosas, Qianqian Liu, Joel Michalek, Adolfo Enrique Diaz Duque. Sociodemographic, access to care and survival outcomes for patients with mantle cell lymphoma: A national cancer database analysis with focus on Hispanics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3818.