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Survival outcomes in diffuse large B-cell lymphoma

Why did we do this study?

As part of YHHN's core activities, audits are carried out to monitor treatment and make sure all patients have equal access to the same treatments, as per local and national guidance. Any differences found are examined to understand why they are occurring, and if necessary, resolve any underlying difficulties to ensure that all patients have access to the best possible care. Diffuse large B-cell lymphoma (DLBCL) is newly diagnosed in around 2,700 people in the UK each year. It is more common in men than women, and whilst it can be diagnosed at any age, it is more common in older people. A recent YHHN audit noted that patients with DLBCL who were treated at one of the hospitals in the area had poorer survival than the others and we explored the reasons for this using our data.

What did we do?

Disease-related information is routinely collected from the medical records of all YHHN patients in the study area, including those with DLBCL. Data were checked, and comparisons made, between each treating hospital, to look for differences that might explain the poorer outcomes seen in the audit.

What did we find?

We found that the hospital in question was a specialist centre, meaning that patients who were sicker, including for example those with disease that had affected their brain, were more likely to be referred to this centre for expert treatment. With this in mind, we concluded that the differences noted in the audit were due to the identified hospital providing care for more very ill patients, who were known to have poorer outcomes in general. This information was very important to the clinical teams, as it reassured them that the variations were due to the type of patients they treated, not differences in care. Also, when we looked at the data again, and took into consideration how poorly the patients were in each hospital at diagnosis and/or referral, no differences by hospital were seen. We were only able to understand this because we collect information from individual patients about their disease, including the areas of the body that are affected. This shows how important it is that we collect such data from all patients living in the YHHN area.