Impact Of a Federal Program On  response Rate & Survival, In a Cohort Of Patients With Diffuse Large B- Cell Lymphoma. Analysis In a Single National Reference Institution In Mexico

The actual standard of care of Diffuse Large B-Cell Lymphoma (DLBCL) includes rituximab in combination with chemotherapy, with overall response rates  up to 76 %.  However, this treatment may not be accessible to many patients because of limited economical resources, particularly in  developing countries, where most of the treatment must be paid from the pocket of patients or their families.   In Mexico, since 2011 a Federal program has fully covered   the treatment of patients with DLBCL. At the Instituto Nacional de Cancerología (INCan) in Mexico city 214  patients with ths disease have been treated without cots with the standard of care.   The   mean age at diagnosis was 56.7 +15.9 (22-91). This series of cases was compared with a retrospective analysis of cases with DLBCL seen at the INCan between 2006-2008  None A total of 264 cases were retrospectively analyzed.  No differences were found in demographic and clinical characteristics at the time of diagnosis. However, a clear  positive impact was found in the group that received full treatment thanks to this new social coverage by this new social security program. The follow-up and completion of treatment was 99%.,   In contrast: from 264 in the retrospective group, 209 (79 %)  were treated, but only 29 (10.9 %) were able to receive an optimal treatment, including rituximab.  These differences in treatments had a clearly impact   on the response rate, as shown in the following table:

These results demonstrate the importance of social programs that may accessible   standard treatment options in countries with limited resources.