Academic Cancer Centers Improve Outcomes for Patients With Mantle Cell Lymphoma
Patients with mantle cell lymphoma (MCL) who receive treatment at academic cancer centers experience longer overall survival and higher participation in clinical trials compared to those treated in community-based practices, according to a study published in Hematology.
“Given the limited data that exist regarding site of care in CLL and MCL, this study was designed to compare patient characteristics, treatment patterns, clinical trial participation, and clinical outcomes of patients by site of care in the current era of treatment for these diseases,” explained Debra Bruno, University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center in Cleveland, OH, and coauthors.
The study, utilizing data from the Flatiron Health electronic health record database, examined 6372 patients with chronic lymphocytic leukemia (CLL) and 3411 with MCL. Researchers compared patient characteristics, treatment patterns, and clinical outcomes between academic and community settings. Only 13.9% of patients with CLL and 22.2% of patients with MCL received treatment in academic centers, which generally treated younger, privately insured patients and had significantly larger practice sizes. Patients in academic centers also had a longer time from diagnosis to first-line therapy, which was 20.5 vs 17.2 months for CLL and 5.5 vs 3.3 months for MCL (both P < .0001).
Treatment approaches varied notably by practice type. Patients in academic centers were significantly more likely to participate in clinical trials (P <. 0001 for CLL; P = .002 for MCL). For MCL, academic centers more frequently utilized CAR-T therapy, transplantation, and cBTKi therapy (all P <.0001).
Survival outcomes also differed by treatment site. Median time to next treatment or death (TTNT-D) was significantly shorter in academic centers—38.3 vs 38.9 months for CLL (HR = 1.16; P = .02) and 18.1 vs 29.1 months for MCL (HR = 1.23; P = .01). Overall survival (OS) was markedly better for patients treated in academic settings. The median OS for CLL patients in community practices was 102.6 months from diagnosis, while OS was not reached in academic centers. For MCL, median OS was 96.5 months in academic centers versus 73.5 months in community settings (P < .01).
“Despite these differences, receipt of care in academic practice centers was associated with significantly longer survival outcomes and higher clinical trial participation,” concluded the study authors.
Reference
Bruno DS, Khanal M, Li X, Escalon MP, Winfree K, Hess LM. Clinical trial participation, clinical care, and patient outcomes by practice setting: a real-world database analysis of patients with Chronic Lymphocytic Leukemia or Mantle Cell Lymphoma. Hematology. 2025;30(1):2457809. doi:10.1080/16078454.2025.2457809
