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Impact of socioeconomic disparities on outcomes in adults undergoing allogeneic hematopoietic cell transplantation for acute myeloid leukemia. | LitMetric

AI Article Synopsis

  • Racial and socioeconomic disparities affect chemotherapy outcomes and access to allogeneic hematopoietic cell transplantation (HCT) for acute myeloid leukemia (AML), but studies show mixed results regarding their impact on post-HCT outcomes.
  • Analyzed data from 1,024 adults who underwent HCT between 2006 and 2021, examining factors like race, marital status, and socioeconomic status, with some interesting findings about how these factors relate to non-relapse mortality and overall survival.
  • The study concluded that, after adjusting for various factors, being married improved survival outcomes, while lack of insurance worsened them, and noted significant differences based on race, calling for more research to fully explore these disparities in HCT

Article Abstract

Racial and socioeconomic disparities impact outcomes after chemotherapy and limit access to allogeneic hematopoietic cell transplantation (HCT) in acute myeloid leukemia (AML), yet studies have yielded mixed results on the influence of disparities on post-HCT outcomes. Therefore, we studied 1024 adults with AML who underwent allogeneic HCT between 5/2006 and 10/2021 at a single large university-affiliated cancer center. Collected data included non-biologic and demographic characteristics (including race/ethnicity, marital status, distance traveled, and household size), transplant- and disease-related characteristics, and area-level and individual-level socioeconomic factors (i.e., area deprivation index and occupational status). After multivariable adjustment, no socioeconomic- or non-biologic factors were associated with non-relapse mortality (NRM), overall survival (OS), relapse-free survival (RFS), or relapse except being married (associated with improved NRM: hazard ratio [HR] = 0.7 [0.50-0.97]) and having no insurance (associated with worse OS: HR = 1.49 [1.05-2.12] and RFS: HR = 1.41 [1.00-1.98]). Despite a relatively racially homogenous cohort, Asian race was associated with improved NRM (HR = 0.47 [0.23-0.93]) and American Indian/Alaskan Native race was associated with higher relapse risk (HR = 2.45 [1.08-5.53]). In conclusion, in our retrospective analysis, socioeconomic-, demographic-, and non-biologic factors had limited impact on post-HCT outcomes in AML patients allografted in morphologic remission. Further research is needed to investigate disparities among HCT-eligible patients.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10997459PMC
http://dx.doi.org/10.1038/s41375-024-02172-3DOI Listing

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