Center for Nursing Research, School of Nursing, Medical College of Georgia, Augusta, Georgia 30912, USA.
Cancer. 2010 Jul 15;116(14):3469-76. doi: 10.1002/cncr.25297.
The purpose of the current study was to determine whether the use of hematopoietic stem cell transplantation (HCT) to treat leukemia, lymphoma, or multiple myeloma (MM) differs by race and sex.
The annual incidence of leukemia, lymphoma, and MM was estimated in the United States in people aged <70 years by race and sex using the Surveillance, Epidemiology, and End Results (SEER) cancer registry between 1997 and 2002 and US census reports for the year 2000. The annual incidence of autologous, human leukocyte antigen (HLA) identical sibling, and unrelated HCT performed in these groups was estimated using Center for International Blood and Marrow Transplant Research data from 1997 through 2002. Logistic regression analysis was used to calculate the age-adjusted odds ratio (OR) of receiving HCT for Caucasians versus African Americans and for men versus women.
The likelihood of undergoing HCT was found to be higher for Caucasians than for African Americans (OR, 1.40; 95% confidence interval [95% CI], 1.34-1.46). This difference existed for each type of HCT: autologous (OR, 1.24; 95% CI, 1.19-1.30), HLA identical sibling (OR, 1.59; 95% CI, 1.46-1.74), and unrelated donor (OR, 2.02; 95% CI, 1.75-2.33). Overall, men were more likely than women to receive HCT (OR, 1.07; 95% CI, 1.05-1.1 [P<.0001]); however, this difference was found to be significant only for autologous HCT (OR, 1.10; 95% CI, 1.07-1.13 [P<.0001]).
HCT is more frequently used to treat leukemia, lymphoma, and MM in Caucasians than in African American individuals. African Americans have lower rates of both autologous and allogeneic HCT, indicating that donor availability cannot fully explain the differences. Women are less likely than men to receive autologous HCT for reasons unexplained by age or disease status.
本研究旨在探讨接受造血干细胞移植（HCT）治疗白血病、淋巴瘤或多发性骨髓瘤（MM）的患者，其种族和性别是否存在差异。
利用美国监测、流行病学和最终结果（SEER）癌症登记处的数据，于 1997 年至 2002 年按种族和性别估计年龄<70 岁人群的白血病、淋巴瘤和 MM 的年发病率，并结合 2000 年美国人口普查报告的数据进行校正。利用国际血液和骨髓移植研究中心 1997 年至 2002 年的数据，估计各年龄组中接受自体、人类白细胞抗原（HLA）完全相合的同胞供者和无关供者 HCT 的年发生率。采用 logistic 回归分析计算与非裔美国人相比，白种人接受 HCT 的年龄校正比值比（OR），以及与女性相比，男性接受 HCT 的 OR。
与非裔美国人相比，白种人接受 HCT 的可能性更高（OR 为 1.40；95%置信区间[95%CI]为 1.34-1.46）。这种差异存在于每一种 HCT 方式中：自体（OR 为 1.24；95%CI 为 1.19-1.30）、HLA 完全相合的同胞供者（OR 为 1.59；95%CI 为 1.46-1.74）和无关供者（OR 为 2.02；95%CI 为 1.75-2.33）。总体而言，男性接受 HCT 的可能性高于女性（OR 为 1.07；95%CI 为 1.05-1.1[P<.0001]）；然而，这种差异仅在自体 HCT 中具有统计学意义（OR 为 1.10；95%CI 为 1.07-1.13[P<.0001]）。
与非裔美国人相比，白种人更常接受 HCT 治疗白血病、淋巴瘤和 MM。非裔美国人接受自体和异基因 HCT 的比例均较低，这表明供者的可用性不能完全解释这种差异。女性接受自体 HCT 的可能性低于男性，但原因尚不清楚。
