While not specific to chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL / SLL), CLL Society is dedicated to increasing awareness of disparities in blood cancer patients’ care and clinical outcomes, and so is sharing this important research.
At the American Society of Hematology Annual Meeting and Exposition, ASH 2021, we learned that we are practicing medicine that is more expensive and provides poorer care to many non-white patients.
Takeaways:
- The study population included 23,952 CLL, 3,387 MCL, 2,655 MZL, and 1,811 WM patients in this US hospital database.
- The use of chemo-immunotherapy was lower in whites compared to non-whites (11.9% vs. 16.2%).
- Non-white patients have significantly longer mean length of stay LOS hospital days than white patients (CLL: 18.3 versus 14.8).
- Across all lymphoma types, higher hospital costs were associated with patients who were non-white, Hispanic/Latino, treated in hospitals located in the Northeast or West, or had Medicaid.
- The statistically significant increased cost of care was also noted for patients who received targeted therapy or supportive care, such as blood transfusion or expensive growth factors.
Conclusions:
Real-world data demonstrated the significantly high total hospital costs once patients with chronic lymphocytic leukemia/small lymphocytic leukemia (CLL / SLL) and other lymphoma were hospitalized, significantly impacting minority populations.
Healthcare providers and patients need to become more aware of how much care has advanced, with chemo-immunotherapy being primarily replaced by targeted therapies that offer fewer side effects, less time in hospital, and better outcomes.
Better outpatient care and the broader use of novel oral targeted agents would decrease expensive hospitalizations and reduce unacceptable but persistent racial disparities in healthcare.
Please watch my monologue here:
Here is a link to the ASH abstract: Real-World Disease Burden, Costs and Resource Utilization of Hospital-Based Care Among Mantle Cell Lymphoma, Waldenström Macroglobulinemia, Marginal Zone Lymphoma and Chronic Lymphocytic Leukemia: Disparities and Risk Factors.
Stay strong. We are all in this together.
Brian Koffman MDCM (retired) MS Ed (he, him, his)
Co-Founder, Executive VP, and Chief Medical Officer, CLL Society, Inc.