Unmarried and less educated patients receive less extensive therapy


Mantle cell lymphoma is a malignant tumour disease where intensive therapy can prolong survival. A new study from IGP and others shows that people with mantle cell lymphoma who were unmarried and had a lower education level were more seldom treated by stem cell transplantation, which can result in reduced survival. The results have been published in the journal Blood Advances.

Patients with mantle cell lymphoma, where the disease has spread, receive extensive treatment with chemotherapy and stem cell transplantation. In the current study the researchers have examined which patients are offered transplantation, compared to those that are not selected for transplantation. The study showed that transplantation increases survival but the people that people who were unmarried and had a lower education level were transplanted more seldom.

“We don’t know exactly why those who were unmarried and had a lower education level were more seldom transplanted, but we can speculate that less social support or lack of information can result in concern about receiving a very challenging therapy, both for the patient and the doctor. In addition, someone with several other diseases cannot tolerate a transplantation,” says Ingrid Glimelius at IGP, who has led the study.

The study included 369 patients from the whole of Sweden, diagnosed with mantle cell lymphoma in the time period 2000 to 2014 and who were between 18 and 65 years old at diagnosis. Among these, 40 per cent did not receive transplantation in the initial treatment, which according to researchers was surprisingly high.

“In some cases, one should not perform a transplantation, for instance if the disease is very quiet or if the patient is too ill to tolerate the treatment. But this study shows that those who were not selected for a transplantation had a clearly reduced survival, which indicates that transplantation is a very important component of the therapy,” says Ingrid Glimelius.

The mortality within hundred days after transplantation was low, which also indicated that it is a safe treatment that likely could have been considered more often in Sweden. For patients that still cannot have a transplantation, the study suggests that modern, targeted drugs should be considered instead of only administering chemotherapy.

“These types of studies are important as they can enable some groups in society to be offered more support. They can also provide an eye-opener both for patients, hospital staff and politicians that there is a need for even more equal care in Sweden,” says Ingrid Glimelius.

The study has been performed in collaboration with researchers at Karolinska Institutet and Lund University, and within the scope of a scientific partnership between Karolinska Institutet and Janssen Pharmaceutika NV.

More information:
Paper in Blood Advances
Ingrid Glimelius’ research