Sigmund Audrey M, Zhao Qiuhong, Jiang Justin, Elder Patrick, Benson Don M, Rosko Ashley, Bumma Naresh, Khan Abdullah, Devarakonda Srinivas, Vasu Sumithira, Jaglowski Samantha, Mims Alice, Choe Hannah, Larkin Karilyn, Brammer Jonathan, Wall Sarah, Grieselhuber Nicole, Saad Ayman, Penza Sam, Efebera Yvonne A, Sharma Nidhi
Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States.
College of Medicine, The Ohio State University, Columbus, OH, United States.
Front Oncol. 2022 Feb 25;12:801879. doi: 10.3389/fonc.2022.801879. eCollection 2022.
Allogeneic hematopoietic stem cell transplant (allo-HCT) is a potential curative therapy for a variety of hematologic disorders. However, it requires highly specialized care that is only available at select centers across the country. Thus, minority populations are at risk for healthcare disparities in access to and outcomes of allo-HCT. Our study aimed to assess the impact of race and location of residence on outcomes of allo-HCT.
We performed a retrospective analysis of all patients who underwent allo-HCT at the Ohio State University from 1984 to 2018. Patients were divided by race (Caucasian, African American, and other) and grouped by zip code into rural, suburban, and urban groups. Primary endpoints included progression-free survival (PFS) and overall survival (OS).
Of the 1,943 patients included in the study, 94.3% self-identified as Caucasian, 4.6% African American, and 1.1% other. In total, 63.4% lived in rural areas, 22.9% suburban, and 13.8% urban. There was no significant difference in OS or PFS by race ( = 0.15, 0.21) or place of residence ( = 0.39, 0.17). In addition, no difference in nonrelapse mortality, acute and chronic graft-versus-host disease (GVHD), and GVHD-free relapse-free survival (GRFS) was seen among the race or place of residence.
Our study suggests that when appropriate access to HCT is given, there is no difference in outcomes based on race, ethnicity or place of primary residence. Further research is needed to further evaluate barriers for these patients to undergo transplant and help mitigate these barriers.
异基因造血干细胞移植（allo-HCT）是治疗多种血液系统疾病的一种潜在的治愈性疗法。然而，它需要高度专业化的护理，而这种护理仅在全国选定的中心才有。因此，少数族裔人群在接受allo-HCT的可及性和治疗结果方面存在医疗保健差异的风险。我们的研究旨在评估种族和居住地点对allo-HCT治疗结果的影响。
我们对1984年至2018年在俄亥俄州立大学接受allo-HCT的所有患者进行了回顾性分析。患者按种族（白种人、非裔美国人及其他）划分，并按邮政编码分为农村、郊区和城市组。主要终点包括无进展生存期（PFS）和总生存期（OS）。
纳入研究的1943例患者中，94.3%自我认定为白种人，4.6%为非裔美国人，1.1%为其他种族。总体而言，63.4%居住在农村地区，22.9%居住在郊区，13.8%居住在城市。OS或PFS在种族（P = 0.15，0.21）或居住地点（P = 0.39，0.17）方面无显著差异。此外，在种族或居住地点之间，非复发死亡率、急性和慢性移植物抗宿主病（GVHD）以及无GVHD无复发生存期（GRFS）也无差异。
我们的研究表明，当给予适当的HCT可及性时，基于种族、民族或主要居住地点的治疗结果并无差异。需要进一步研究以进一步评估这些患者接受移植的障碍并帮助减轻这些障碍。
