Therapeutic Utilisation Across the Spectrum of Lymphoma and Chronic Lymphocytic Leukaemia
An Analysis of the Lymphoma Coalition’s 2022 Global Patient Survey
Authors: Steve Kalloger¹, Natacha Bolaños¹, Amanda Watson¹, Shawn Sajkovski¹, Lorna Warwick¹
¹ Lymphoma Coalition, Mississauga, ON, Canada
Background
The utilisation of autologous haematopoietic stem cell transplant (ahSCT) is one of many therapeutic options for patients with lymphoma. A gap exists in the knowledge base for the utilisation of this treatment modality from a global and pan-subtype perspective. In this study, we sought to explore the use of ahSCT and other treatment regimens from a cross-sectional view in the context of lymphoma and chronic lymphocytic leukaemia (CLL).
Methods
Patients with lymphoma or CLL from around the world were offered the opportunity to participate in the Lymphoma Coalition’s Global Patient Survey in 2022. Respondents specified which treatment(s) they had received. Additional information on country, subtype of residence, and various demographics were collected.
The incidence of ahSCT was examined along with other therapies to provide an overview of how treatments differed by subtype across the globe.
Valid responses were collected for 5280 patients from 66 countries, which were input into independent regression for further analysis. Younger patients were significantly more likely to receive ahSCT (S1 vs. S7 years; p < 0.0001). Biological sex was not a significant predictor. The use of CAR-T was significantly elevated in those who received ahSCT (OR = 5.57; 95% CI = 3.55–8.71).
Results
Utilisation of ahSCT by Subtype
- Peripheral T-Cell (n=22): 50%
- Angioimmunoblastic T-Cell (n=24): 38%
- Adult T-Cell (n=17): 23%
- Anaplastic Large Cell (n=48): 23%
- Mantle Cell (n=197): 40%
- Other Aggressive Lymphoma (n=153): 20%
- Diffuse Large B-Cell (DLBCL) (n=679, not otherwise specified): 20%
Note: Subtypes of Peripheral T-Cell lymphoma where ahSCT is recommended in clinical practice guidelines.
Regional Differences in Rate of Utilisation
- Middle East & Africa (n=202): 31%
- South America (n=265): 23%
- Europe (n=1426): 13%
- Asia-Pacific (n=742): 11%
- North America (n=945): 4%
Observation: The low rate in North America could possibly be due to the general trend of certain aggressive subtypes within the respondent populations from the United States.
Experience of Patients Who Received ahSCT
- Had at least one relapse (n=421): 70%
- Experienced at least one relapse (≥2 relapses) (n=236): 60%
Conclusion: Patients who receive ahSCT are likely to require more than one therapeutic regimen during their treatment journey, either alone or in combination with other therapies.
Conclusion
The results of this study indicate that patients who receive ahSCT are more likely to require more than one therapeutic regimen. Current trends in therapy include the expansion of monoclonal antibodies, bispecific antibodies, and antibody-drug conjugates, which allow patients to prolong their lives and manage their lymphomas.
The recent approval of CAR-T therapies allows us to continue to investigate its role in the therapeutic regimen sequence. There remains an unmet need for less aggressive lymphomas, which reflect lower rates of ahSCT and possibly lower access to novel therapies. The greatest unmet need is the expansion of lymphoma treatments and the need to achieve equity in access across the globe.
Funding
This research was supported by AbbVie, BMS, Pharmacyclics, and Roche.
The Lymphoma Coalition is responsible for this research.
Contact Information
For further details, please visit:
www.lymphomacoalition.org/global-patient-survey
Research Department Contact:
📧 stevek@lymphomacoalition.org
🌐 www.ebmt.org
Summary
- Study aim: To examine global utilisation of autologous haematopoietic stem cell transplant (ahSCT) across lymphoma subtypes using data from the Lymphoma Coalition’s 2022 Global Patient Survey (5280 patients, 66 countries).
- Key findings:
- Younger patients were significantly more likely to receive ahSCT.
- Subtypes with higher ahSCT use: Peripheral T-Cell (50%), Mantle Cell (40%), Angioimmunoblastic T-Cell (38%).
- CAR-T use was significantly more common in patients who had also received ahSCT.
- Regional differences in ahSCT use:
- Highest: Middle East & Africa (31%), South America (23%).
- Lowest: North America (4%).
- Patient experience:
- 70% of ahSCT recipients had at least one relapse.
- 60% had multiple relapses.
- Conclusion:
Patients receiving ahSCT typically need multiple therapies across their treatment journey. Expansion of access to novel therapies (e.g., monoclonal antibodies, bispecifics, CAR-T) remains a priority, especially for less aggressive lymphomas and in regions with low utilisation.