Utilization of Autologous Hematopoietic Cell Transplantation Over Time in Multiple Myeloma: A Population-Based Study.
Clin Lymphoma Myeloma Leuk
; 24(4): e119-e129, 2024 04.
Article
in En
| MEDLINE
| ID: mdl-38195324
ABSTRACT
PURPOSE:
Autologous hematopoietic cell transplantation (autoHCT) is associated with survival benefits in multiple myeloma (MM), but utilization remains low and differs by sociodemographic factors. Prior population-based studies have not fully captured autoHCT utilization or examined relationships between sociodemographic factors and autoHCT trends over time. PATIENTS ANDMETHODS:
We used a novel data linkage between the California Cancer Registry, Center for International Blood and Marrow Transplant Research, and hospitalizations to capture autoHCT in a population-based MM cohort (n = 29, 109; 1991-2016). Due to interactions by treatment era, stratified multivariable Cox proportional hazards regression models determined factors associated with autoHCT.RESULTS:
The frequency of MM patients who received autoHCT increased from 5.7% (1991-1995) to 27.4% (2011-2016). In models by treatment era, patients with public/no (vs. private) health insurance were less likely to receive autoHCT (2011-2016 Medicare hazard ratio (HR) 0.70, 95% confidence interval (CI) 0.63-0.78; Medicaid HR 0.81, CI 0.72-0.91; no insurance HR 0.56, CI 0.32-0.99). In each treatment era, Black/African American (vs. non-Hispanic White) patients were less likely to receive autoHCT (2011-2016 HR 0.83, CI 0.72-0.95). Hispanic patients were less likely to undergo autoHCT, most prominently in the earliest treatment era (1991-1995 HR 0.58, 95% CI 0.37-0.90; 2011-2016 HR 1.07, CI 0.96-1.19). Patients in lower socioeconomic status neighborhoods were less likely to utilize autoHCT, but differences decreased over time.CONCLUSIONS:
Despite increases in autoHCT utilization, sociodemographic disparities remain. Identifying and mitigating barriers to autoHCT is essential to ensuring more equitable access to this highly effective therapy.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Hematopoietic Stem Cell Transplantation
/
Multiple Myeloma
Type of study:
Prognostic_studies
Limits:
Aged
/
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
Clin Lymphoma Myeloma Leuk
/
Clin. lymphoma myeloma leuk. (Online)
/
Clinical lymphoma myeloma & leukemia (Online)
Journal subject:
NEOPLASIAS
Year:
2024
Document type:
Article
Country of publication: