Insurance-based disparities impact survival outcomes in Waldenström macroglobulinemia within the United States

Karan L. Chohan, Jithma P. Abeykoon, Stephen M. Ansell, Morie Gertz, Prashant Kapoor, Aneel Paulus, Sikander Ailawadhi, Craig B Reeder, Thomas E. Witzig, Thomas M. Habermann, Martha Lacy, Robert A. Kyle, Ronald S. Go, Jonas Paludo

Research output: Contribution to journalArticlepeer-review


Considerable healthcare resource utilization and financial burden have been associated with the treatment of WM; however, the impact of health insurance status on outcomes has not been previously reported. We conducted a National Cancer Database analysis of newly diagnosed cases of active WM between 2004 and 2017 to evaluate the impact of insurance status on outcomes. For patients <65 years old (n = 1249, male sex: 62.4%, median age: 58 years), significant insurance-based survival differences were observed on multivariable analysis; patients who were uninsured [n = 63; HR 3.11 (95%CI, 1.77–5.45), p < 0.001], on Medicaid [n = 87; HR 1.88 (95% CI, 1.01–3.48), p = 0.045], or on Medicare [n = 122; HR 2.78 (95%CI, 1.76–4.38), p < 0.001], had inferior survival compared to patients with private insurance (n = 977; reference). In patients ≥65 years, no insurance-based survival differences were found (p = 0.10). Overall, significant insurance-based outcome disparities exist in WM. Further work is desperately needed to systematically uncover and address these disparities.

Original languageEnglish (US)
JournalLeukemia and Lymphoma
StateAccepted/In press - 2022


  • healthcare
  • lymphoplasmacytic lymphoma
  • NCDB analysis
  • Non-Hodgkin lymphoma
  • Waldenström macroglobulinemia

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


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