Patient Factors Associated with Upfront Stem Cell Transplant for MCL

A study found that for people with mantle cell lymphoma (MCL), patient demographics were associated with likelihood of receiving upfront autologous stem cell transplantation (ASHCT), as well as five-year survival. These data were published in Leukemia & Lymphoma.

For this study, the investigators utilized the National Cancer Database to evaluate patients with newly diagnosed MCL who were treated with chemotherapy with or without upfront ASCT. In total, 10290 patients met inclusion criteria. The rate of ASCT use was 17%.

Younger patients were more likely than older patients to receive transplant, as well as patients with fewer comorbidities. Other factors associated with upfront transplant included being privately insured, having higher income and education levels, and receiving treatment at an academic center. Multivariable analysis found that age, comorbidity index scores, insurance type, transition of care, facility type, distance to facility, and year of diagnosis were predictive for ASCT use.

The use of ASCT was associated with greater five-year overall survival (OS) in both younger and older patients. For younger patients, five-year OS with versus without ASCT was 82% vs. 64% (P <0.001). For older patients, five-year OS was 70% vs. 40% (P <0.001), respectively. This difference in survival for patients treated with ASCT was consistent in the matched propensity score and in the 12-month analyses.

Factors associated with improved OS were female sex, diagnosis year after 2009, private insurance, higher income, and education. The researchers noted that Black race and a higher number of comorbidities were associated with inferior survival.

Reference

Sawalha Y, Radivoyevitch T, Jia X, et al. The impact of socioeconomic disparities on the use of upfront autologous stem cell transplantation for mantle cell lymphoma. Leuk Lymphoma. 2021 Sep 15;1-9.