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

Karan L. Chohan, Jithma P. Abeykoon, Stephen M. Ansell, Morie A. Gertz, Prashant Kapoor, Aneel Paulus, Sikander Ailawadhi, Craig B. Reeder, Thomas E. Witzig, Thomas M. Habermann, Martha Q. 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)
Pages (from-to)2879-2888
Number of pages10
JournalLeukemia and Lymphoma
Issue number12
StatePublished - 2022


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

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


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