Treatment Facility Type Impacts Survival in Mantle Cell Lymphoma

Patients with mantle cell lymphoma (MCL) treated at academic and research programs experienced significantly longer overall survival (OS) compared with those treated at community-based facilities in a large, national analysis spanning nearly 2 decades.1 The findings, presented at the American Society of Hematology 2025 Annual Meeting & Exposition, suggest that treatment setting plays an independent and meaningful role in outcomes for this rare and often aggressive B-cell malignancy.

The superior survival seen at ACPs was likely driven by earlier MCL treatment initiation, increased chemoimmunotherapy use, and better access to the latest treatments and clinical trials, according to the authors. | Image credit: Eleni - stock.adobe.com

“MCL frequently presents with advanced-stage disease and may involve extra nodal sites such as bone marrow and gastrointestinal tract,” the authors explained. “While therapeutic options have expanded to include chemoimmunotherapy, targeted agents, and stem cell transplantation, outcomes remain variable. Emerging evidence suggests that sociodemographic factors—including race, ethnicity, insurance status, and treatment setting—may influence outcomes in MCL, yet data on how these disparities manifest across facility types are limited.”

Investigators analyzed data from the National Cancer Database for 40,479 patients diagnosed with MCL between 2004 and 2022. Patients were categorized by treatment facility type: academic cancer programs (ACPs), which included academic and National Cancer Institute–designated centers, and community cancer programs (CCPs), which encompassed community, comprehensive community, and integrated network programs.

Most patients (58%) received care at ACPs, while 42% were treated at CCPs. The cohort was predominantly male (71%) and White (92%), with Hispanic patients accounting for 5.6% of cases. Hispanic patients were significantly younger at diagnosis, more likely to be uninsured or covered by Medicaid, and more likely to live in lower-income neighborhoods compared with non-Hispanic patients

Notable differences emerged between patients treated at academic vs community facilities. Those treated at ACPs were younger (median age, 67 years vs 70 years), more likely to have private insurance (42% vs 33.5%), and more likely to have higher educational attainment. In contrast, patients treated at CCPs were more likely to live in rural areas and in Medicaid nonexpansion states (49% vs 35%; P < .001). While patients treated at academic centers traveled longer for care (median 10.5 miles vs 6.5 miles; P < .001), they experienced shorter times to treatment initiation (median 28 vs 31 days; P = .014).

Those treated at ACPs were more likely to receive treatment vs those treated at CCPs (75% vs 66%; P < .001) and chemotherapy combined with immunotherapy was more commonly received at ACPs. The adjusted median OS was 10.2 years for patients treated at ACPs vs 8.8 years in the CCP setting (P < .001). Kaplan-Meier estimates showed improved OS at 2 years (79% vs 76%), 5 years (63% vs 59%), and 10 years (45% vs 40%) for patients treated at ACPs. After adjustment for age, race and ethnicity, insurance status, comorbidities, and distance traveled, treatment at an academic center remained independently associated with improved OS (HR, 0.87; 95% CI, 0.84-0.91).

“Despite treating a more socioeconomically diverse and medically complex population, ACPs consistently achieved better long-term outcomes than CCPs,” the authors concluded. “These findings highlight the essential role of academic centers in delivering high-quality, guideline-concordant lymphoma care and underscore the need to reduce barriers to specialized treatment.”

The MCL treatment landscape continues to evolve, including advances such as targeted therapy with or without chemoimmunotherapy, making access to these treatments important to optimize outcomes.2

The study was the most comprehensive to date in MCL, according to the authors, and the superior survival at ACPs was likely driven by earlier treatment initiation, increased chemoimmunotherapy use, and better access to the latest treatments and clinical trials.1

“Expanding access to academic-level care—whether through referral networks, community-academic partnerships, or telemedicine—may help close survival gaps and improve outcomes for patients with MCL.”

References

1. Atalla E, Ascencio YO, Velez-Mejia C, et al. Impact of treatment facility type on survival outcomes in mantle cell lymphoma: a 20-year NCDB analysis. Presented at: ASH 2025; December 6-9, 2025; Orlando, FlorFLida. Abstract 3572.

2. Noor WD, Cheah CY. Recent advances and future directions in newly diagnosed mantle cell lymphoma. Expert Opin Pharmacother. 2025;26(13):1415-1432. doi:10.1080/14656566.2025.2556138