Abstract A007: Treatment setting, socio-demographic factors, and survival of patients with mature lymphoid malignancies (MLM)

Abstract Background: Geographic, economic, and sociodemographic factors impact survival in MLM. We aimed to examine how these factors impact survival in patients seen in either the outpatient or inpatient clinical context. Methods: Retrospective cohort study of two large national datasets, the Surveillance Epidemiology and End Results (SEER) 2010-2020 and National Inpatient Sample (NIS) 2016-2020. We included patients≥ 15 years with multiple myeloma (MM), classic Hodgkin Lymphoma (cHL), indolent B-cell lymphoma (iBCL), aggressive B-cell lymphoma (aBCL), cutaneous T-cell lymphoma (CTCL), peripheral T-cell lymphoma (PTCL), extranodal T-cell lymphoma (ENTCL), NK-T-cell lymphoma, and multiple myeloma (MM). Demographic characteristics were compared across subgroups using the χ2 test and the ANOVA F-test. Univariate and multivariate analyses of overall survival (OS) were performed using sociodemographic factors in the SEER database. Significant factors were assigned weighted points to construct a novel access to care (ATC) score, which was included in the final Cox model. In the NIS, multivariate logistic regression models were fit to assess sociodemographic variables associated with in-hospital mortality. Results: The SEER cohort (N=33,913)included 8.36% cHL, 18.98% iBCL, 23.93% aBCL, 6.59%TCL, and 42.14% MM. Widowed marital status (aOR 1.49 (1.36 – 1.62), lower income quartiles, and rural location were significantly associated with low OS and were used to generate ATC scores ranging from 0-5. ATC scores of 2 aOR 1.10 (1.01 – 1.21), 3 aOR 1.20 (1.09 – 1.33), and 4 aOR 1.35 (1.18 – 1.53) were incrementally associated with low OS compared to an ATC score of 0. Sensitivity analyses stratified by race, age, and MLM type showed consistent results in key subgroups compared to the whole cohort. The NIS cohort (N= 300,677) included 1.51% cHL, 33.36% iBCL, 25.65% aBCL, 1.21% CTCL, 1.46% PTCL, 0.53% ENTCL, 0.13% NKTCL, and 36.15% MM. iBCL was more common in Whites (86.09%); CTCL (25.21%), ENTCL (35.68%), and MM (23.38%) in Blacks, and NKTCL in Hispanics. The overall in-hospital mortality rate was 4.98%, highest in NKTCL (8.91%) and lowest in classic HL (2.38%). A higher odd of in-hospital mortality was seen with older age ≥ 65 vs 15-39 yr; aOR 2.57 (2.19-3.00), Black race aOR 1.10 (1.04-1.16), Non-Medicare Insurance, Teaching Hospitals aOR 1.12 (1.06-1.17), while lower odds were seen with female sex aOR 0.85 (0.82-0.88), higher income quartiles, and hospital region South vs North-East AOR 0.87 (0.82-0.92). Conclusion: In our analysis of 300,000 patients with MLM, taken from two US national datasets, decreased access to care—due to geographic distance, economic hardship, or lack of social support—was associated with shorter OS in patients evaluated in the outpatient setting. In-hospital mortality was predominantly impacted by disease biology, medical insurance, and demographics. The cancer care setting interacts with sociodemographic factors and should be considered in future studies. Citation Format: Ted O. Akhiwu, Natalie Akoto, Max Gordon. Treatment setting, socio-demographic factors, and survival of patients with mature lymphoid malignancies (MLM) abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A007.