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Utilization of Autologous Hematopoietic Cell Transplantation Over Time in Multiple Myeloma: A Population-Based Study
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4 2024
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Source: Clin Lymphoma Myeloma Leuk. 24(4):e119-e129
[PDF-1.21 MB]
Details:
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Alternative Title:Clin Lymphoma Myeloma Leuk
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Personal Author:
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Description: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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Pubmed ID:38195324
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Pubmed Central ID:PMC11624524
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Volume:24
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Issue:4
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