Access Inequities and System Capacity for Lymphoma Care in Latin America: Results From the Grupo de Estudio Latinoamericano de Linfoproliferativos Consortium.

Abstract

The integration of diagnostic tools, immunochemotherapy, targeted agents, and cellular therapies such as chimeric antigen receptor T-cell therapy (CAR-T) cells has transformed lymphoma outcomes in high-income countries. However, in Latin America (LATAM), access to these advances remains limited. This study aimed to assess lymphoma care access and institutional capacity in LATAM. We conducted a cross-sectional digital survey from July 2025 to August 2025, coordinated by the Grupo de Estudio Latinoamericano de Linfoproliferativos network. The survey captured center-level data covering infrastructure, human resources, diagnostic and therapeutic availability, and clinical research activity. Data were analyzed using descriptive methods. A total of 73 hematology centers from 16 Latin American countries completed the survey. Most centers were public institutions (53%), with a median number of four hematologists per center (range, 2-10). While basic pathology and flow cytometry were widely available, access to advanced diagnostics was limited. Fifteen centers (21%) lacked immunohistochemistry, and pathology turnaround times exceeded 3 weeks in 56%. Positron emission tomography-computed tomography was available in 41% of centers. Novel therapies such as antibody-drug conjugates, bispecific antibodies, and checkpoint inhibitors were not available or restricted in most centers. Hematopoietic stem-cell transplantation was performed in 41% of centers, whereas commercial CAR-T was available in 5%. Clinical trials were conducted in 34% of centers. Our findings highlight striking disparities between guideline-recommended lymphoma care and real-world institutional capacity across LATAM, underscoring the importance of collaborative efforts in building capacity and advocating for equitable access.