BACKGROUND: Prognostic models in peripheral T cell lymphoma (PTCL) have identified biological factors including age, performance status, LDH, and BM involvement as prognostic for survival. The association of social determinants of health (SDH), on PTCL outcomes remains unexplored. METHODS: To evaluate the impact of actionable SDH on PTCL mortality across race groups, we conducted a retrospective cohort study that included all White, Hispanic, Asian/Pacific Islander (PI) and Black adult patients with nodal PTCLs , diagnosed 2000-2020, in California. We utilized Chi FINDINGS: Our analysis included 6158 patients: 51.8% White, 25.8% Hispanic, 14.7% Asians/PI, and 7.6% Black. Hispanics exhibited the longest median survival (33 months) followed by Whites, Blacks, and Asian/PI (25, 20, and 14 months, respectively
P = .011). Risk factors independently associated with inferior lymphoma-specific survival (LSS) included Asian/PI compared with NH Whites (HR, 1.23
95% CI, 1.10-1.34
P = .0002), AITL/ALCL compared with PTCL, NOS (AITL HR, 1.14
95% CI, 1.02-1.25
P = .011
ALCL HR, 1.15
95% CI, 1.04-1.26
P = .004), academic compared to nonacademic facility-type (HR 0.71
95% CI, 0.64-0.77
P <
.01), Medicare compared with uninsured (HR 1.48, 95% CI, 1.25-1.73
P <
.01), and the lowest 3 compared to the highest education quartiles (Q2 HR 1.13
95% CI, 1.01-1.25
P = .021
Q3 HR 1.14
95% CI, 1.02-1.26
P = .018
Q4 HR 1.22
95% CI, 1.08-1.36
P <
.001). In the least resourced patients, histology, treatment, treatment facility-type, payer and education were independently prognostic for LSS. Academic center treatment was associated with a striking improvement in LSS (academic institution: yes = 101 months, no = 17 months
P <
.01). INTERPRETATION: Treatment facility-type, payer and education, areindependent actionable SDH for PTCL mortality. Treatment center-type had the strongest prognostic association with LSS, conferring a risk reduction of PTCL mortality by nearly 30%.