‘Dramatic’ Decrease in Lymphoma Treatment Access in Ukraine Since War

Ukrainians newly diagnosed with lymphoma have experienced a “dramatic” decrease in access to specialized care, with registration rates reduced by more than half since the beginning of the Russian-Ukrainian war, according to a new study.

Yana Stepanishyna, PhD, of the National Cancer Institute in Kyiv, Ukraine, and colleagues conducted the research and presented their results at the 2022 American Society of Hematology Annual Meeting.

“The [Ukrainian Lymphoma Registry] was launched by the Ukrainian National Cancer Institute and accounts for seven contributing institutions at the start of hostilities …. On 24 February 2022, a full-scale armed conflict broke out in Ukraine, including Kyiv, leading to the displacement of the population to safer regions,” Dr. Stepanishyna and colleagues wrote. “As a consequence, many patients [with lymphoma] lost the opportunity to be referred to specialized hematologic centers, and to be treated according to the most appropriated up-to-date strategies.”

Dr. Stepanishyna and colleagues assessed the war’s impact on patient access to specialized centers by comparing registration rates from February 24, 2022, to July 15, 2022, with registration rates during the same period before the war. They used data from the Ukrainian Lymphoma Registry, which began prospectively collecting information in 2019 on baseline clinical and pathological characteristics, first-line treatments, and responses in all patients with new cases of malignant lymphoma. The database included 639 patients with newly diagnosed malignant lymphoma who were registered from October 2019 to July 2022.

Prior to “the outbreak of hostilities” in February 2022, 611 patients were registered in the Ukrainian Lymphoma Registry, with an average of 22 registrations monthly, according to the researchers. Registrations from February 24 to July 15, 2022, were less than that of the same period in the previous year. Registration rates fell by 56%, from 63 patients in that period in 2021 to 28 patients in that period in 2022, “although the seven intuitions contributing to the [Ukrainian Lymphoma Registry] continued their efforts to maintain diagnostic and therapeutic activities,” Dr. Stepanishyna and colleagues wrote.

Between February 24 and April 30, 2022, only two new patients were admitted, while nine patients were admitted in May 2022, 11 were admitted in June 2022, and six were admitted from July 1 to July 15, 2022.

“Since the start of the war, a dramatic 56% decrease in the number of newly diagnosed lymphoma patients [were] admitted to the seven institutions participating to the [Ukrainian Lymphoma Registry],” Dr. Stepanishyna and colleagues concluded. “Most likely this situation will undoubtedly have a relevant impact on the access to appropriate treatments and ultimately will translate in a reduced chance of cure and long-term survival. When the analysts calculate the costs of the war, we should also take in account the number of lives lost, not on the battle fields, but for denied access to treatments.”

Reference

Stepanishyna Y, Kriachok I, Shokun N, et al. The dramatic impact of the war on access to treatment for lymphoma patients: a report from the Ukrainian Lymphoma Registry. Abstract #4286. Presented at the 64th ASH Annual Meeting and Exposition; December 10-13, 2022; New Orleans, Louisiana.