Introduction:T-cell lymphomas (TCL) are a heterogenous group of aggressive lymphoid malignancies associated with limited therapeutic options and poor patient outcomes. Real-world barriers to treatment access remain poorly described, yet understanding these is vital for improving care equity.Objectives:This study aimed to identify clinical and socioeconomic factors associated with treatment disparities among TCL patients and to characterize patterns in access to novel therapies and clinical trial participation in a large US-based cohort.Methods:A retrospective cohort review was conducted of 400 primary TCL patients treated at Fred Hutchinson Cancer Center/University of Washington from 2014–2024. Demographic, clinical, and insurance-related data were extracted from electronic medical records. Statistical analyses included Wilcoxon rank sum tests for continuous variables and Pearson's chi-squared or Fisher's exact tests for categorical variables.
Results:Sixty-one percent of patients were male, 69% non-Hispanic white, 13% Asian/Pacific Islander, 8.4% Hispanic/Latino, and 7.2% African American. Most patients (89%) had health insurance, yet insured patients were 6.4 times more likely to receive brentuximab vedotin than uninsured patients (32% vs 5%, p=0.013), and only insured patients participated in clinical trials (7.8% vs 0%, p=0.025). Treatment patterns and trial enrollment varied significantly by TCL subtype and insurance status (p< 0.001).Conclusion:Significant disparities in access to novel therapies and clinical trials persist for TCL patients, driven by insurance status and disease subtype. Targeted efforts addressing structural barriers are needed to ensure equitable treatment and advance outcomes in this underserved population.
