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Utilization of Autologous Hematopoietic Cell Transplantation Over Time in Multiple Myeloma: A Population-Based Study.
Esteghamat, Naseem S; Brunson, Ann; Rosenberg, Aaron S; Schonfeld, Sara J; Valcarcel, Bryan; Abrahão, Renata; Cooley, Julianne J P; Meyer, Christa L; Auletta, Jeffery J; Morton, Lindsay M; Muffly, Lori; Wun, Ted; Keegan, Theresa H M.
Affiliation
  • Esteghamat NS; Division of Malignant Hematology, Cellular Therapy and Transplantation, University of California Davis Comprehensive Cancer Center, Sacramento, CA. Electronic address: nsesteghamat@ucdavis.edu.
  • Brunson A; Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA.
  • Rosenberg AS; Division of Malignant Hematology, Cellular Therapy and Transplantation, University of California Davis Comprehensive Cancer Center, Sacramento, CA.
  • Schonfeld SJ; Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD.
  • Valcarcel B; Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD.
  • Abrahão R; Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA.
  • Cooley JJP; California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, Sacramento, CA.
  • Meyer CL; Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN.
  • Auletta JJ; Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN; Divisions of Hematology/Oncology/BMT and Infectious Diseases, Nationwide Children's Hospital, Columbus, OH.
  • Morton LM; Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD.
  • Muffly L; Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University, Stanford, CA.
  • Wun T; Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA; California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Ca
  • Keegan THM; Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA; California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Ca
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 AND

METHODS:

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.
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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:

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: