Impact of Demography, Ethnicity, Co-morbidities and Inequalities on Outcomes in High-Grade Lymphoma Across the UKCHART Network (DECIPHER)

DECIPHER - Impact of Demography, Ethnicity, Co-morbidities and Inequalities on Outcomes in High-Grade Lymphoma Across the UKCHART Network

DECIPHER is a retrospective multicentre observational cohort study using data collected across UKCHART sites. The study will evaluate the impact of ethnicity, socioeconomic deprivation and comorbidity burden on treatment delivery and outcomes in adults diagnosed with DLBCL between 2021 and 2025.

Study Overview

• Status: Not yet recruiting
• Conditions: Impact of Demography, Ethnicity, Co-morbidities and Inequalities on Outcomes in High-Grade Lymphoma Across the UKCHART Network

Detailed Description

Despite the provision of universal healthcare through the National Health Service (NHS), variation in treatment delivery and outcomes among patients with diffuse large B-cell lymphoma (DLBCL) persists. Previous UK population-based studies have demonstrated that socioeconomic factors and multimorbidity influence survival outcomes in aggressive lymphoma, with patients from more deprived backgrounds experiencing poorer outcomes than those from less deprived areas (Smith et al., 2015; Smith et al., 2021a). Furthermore, multimorbidity has been associated with diagnostic delay and emergency presentation, factors known to adversely affect lymphoma outcomes (Smith et al., 2021b).

National datasets such as the National Cancer Registration and Analysis Service (NCRAS) and the Systemic Anti-Cancer Therapy (SACT) database provide valuable population-level real-world evidence and have improved understanding of lymphoma outcomes at a national level. However, these datasets often lack the detailed clinical information required to fully explore the impact of ethnicity, socioeconomic deprivation, frailty, comorbidity burden, treatment modifications, and treatment delivery on patient outcomes.

The UK Consortium for Haematology Audit, Real-world Data and Trials (UKCHART) provides a unique opportunity to address these evidence gaps. Through a network of participating NHS organisations serving a large, diverse, and geographically distributed population, UKCHART enables the collection of detailed patient-level clinical data that are not routinely available within national registries. The demographic diversity of the UKCHART population makes it particularly well suited to investigating healthcare inequalities and understanding how ethnicity, deprivation, and comorbidity influence treatment delivery and outcomes in patients with DLBCL.

This study will utilise the UKCHART network to evaluate the impact of ethnicity, socioeconomic deprivation, and comorbidity burden on the delivery of frontline chemoimmunotherapy and subsequent clinical outcomes in patients with newly diagnosed DLBCL. By generating contemporary UK real-world evidence, the study aims to identify potentially modifiable factors contributing to outcome disparities and inform future strategies to improve equity of care for patients with high-grade lymphoma.

• Study Type: Observational
• Enrollment (Estimated): 2000

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

Data will be collected retrospectively by the 21 individual trusts which make up UKCHART. The population catchment is around 18 million.

Description

Inclusion Criteria:

• Adults aged ≥18 years.
• Newly diagnosed DLBCL.
• Managed within participating UKCHART sites.

Exclusion Criteria:

• Transformed lymphoma.
• Insufficient linkage data.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Treatment completion	Delivered versus planned number of frontline chemoimmunotherapy cycles	Time Period between 2021-2026
Dose intensity reduction	Occurrence and magnitude (%) of chemotherapy dose reductions, particularly reductions >25% from planned treatment	Time Period between 2021-2026

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Overall Survival (OS)	Measured as time from diagnosis (or treatment start, as defined in the SAP) to death from any cause	Time Period between 2021-2026
Progression-Free Survival (PFS)	Measured as time from diagnosis/treatment initiation to disease progression, relapse, or death.	Time Period between 2021-2026
Stage at Diagnosis	Measured using Ann Arbor stage recorded at diagnosis	Time Period between 2021-2026
Time to Treatment Initiation	Measured as the interval between diagnosis and commencement of first-line treatment.	Time Period between 2021-2026

Collaborators and Investigators

• Sponsor: The Royal Wolverhampton Hospitals NHS Trust

Study record dates

Study Major Dates

• Study Start (Estimated): October 1, 2026
• Primary Completion (Estimated): September 1, 2027
• Study Completion (Estimated): September 1, 2027

Study Registration Dates

• First Submitted: September 4, 2026
• First Submitted That Met QC Criteria: September 4, 2026
• First Posted (Actual): September 10, 2026

Study Record Updates

• Last Update Posted (Actual): September 10, 2026
• Last Update Submitted That Met QC Criteria: September 4, 2026
• Last Verified: September 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 2026HAE151