Asian, Black, Hispanic Patients With DLBCL Face Longer Times to CAR-T Infusion

Asian, Black, and Hispanic patients with lymphoma have longer wait times from initial consultation to treatment (“brain-to-vein” time) than White patients, according to a new study being presented at the 2024 American Society of Hematology Annual Meeting & Exposition.

Studies show that CD19-directed chimeric antigen receptor T-cell (CAR-T) therapy effectively treats relapsed or refractory diffuse large B-cell lymphoma (DLBCL). However, logistical challenges can complicate this treatment.

Recent studies show insurance status affects brain-to-vein time, but the impact of race/ethnicity has not been studied. For this study, Dr. Anna Alperovich and colleagues from New York-Presbyterian/Weill Cornell Medical Center explored the differences in brain-to-vein times and outcomes between patients with DLBCL who are White, Asian, Black, or Hispanic.

The study included data from 80 patients treated at New York-Presbyterian/Weill Cornell Medical Center from 2019 to 2023. Of the patients, 52 self-identified as White, 6 as Black, 12 as Asian, and 10 as Hispanic. The median age of all patients in the study was 67.

Dr. Alperovich and colleagues found that vein-to-vein times (time from apheresis, eg, collection of blood cells to infusion) were similar between White patients and patients of color (average, 40 vs 32 days). However, they found that Black, Asian, and Hispanic patients with DLBCL had a longer brain-to-vein time than White patients (average, 54 vs 42 days).

The researchers also observed that response rates and survival outcomes were comparable across Black/Asian/Hispanic patients versus White patients:

• Overall response rates were 68% versus 63%, respectively
• One-year overall survival was 70% versus 68%, respectively
• One-year event-free survival was 48% versus 37%, respectively

Dr. Alperovich and colleagues did not observe any association between race and insurance status or brain-to-vein time and insurance type.

The researchers concluded, “These findings suggest that historically marginalized groups may be at risk for longer wait times for life-saving therapy regardless of insurance status, highlighting the importance of elucidating the social determinants of health that may be contributing. To ensure equitable access to CAR-T cell therapy, larger studies are needed to assess how inequities in health care and social determinants of health result in care delays in at-risk groups.”

Reference

Easwar N, Alperovich A, Gomez-Arteaga A, et al. Non-White and Hispanic Patients Have Significantly Longer Time from Intent to CAR T Infusion (“Brain-to-Vein” Time) in Multiply Relapsed Diffuse Large B Cell Lymphoma. Abstract #2351. Presented at the 2024 American Society of Hematology Annual Meeting & Exposition; December 7-10, 2024; San Diego, California.