Hispanics have the lowest stem cell transplant utilization rate for autologous hematopoietic cell transplantation for multiple myeloma in the United States: A CIBMTR report. Issue 16 (4th May 2017)

• Record Type: Journal Article
• Authors: Schriber, Jeffrey R.; Hari, Parameswaran N.; Ahn, Kwang Woo; Fei, Mingwei; Costa, Luciano J.; Kharfan‐Dabaja, Mohamad A.; Angel‐Diaz, Miguel; Gale, Robert P.; Ganguly, Siddharatha; Girnius, Saulius K.; Hashmi, Shahrukh; Pawarode, Attaphol; Vesole, David H.; Wiernik, Peter H.; Wirk, Baldeep M.; Marks, David I.; Nishihori, Taiga; Olsson, Richard F.; Usmani, Saad Z.; Mark, Tomer M.; Nieto, Yago L.; D'Souza, Anita
• Is Part Of: Cancer. Volume 123:Issue 16(2017)
• Page Start: 3141
• Page End: 3149
• Publication Date: 2017-05-04
• Subjects: blacks -- Hispanic -- myeloma -- transplantation utilization; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.30747
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract : BACKGROUND: Race/ethnicity remains an important barrier in clinical care. The authors investigated differences in the receipt of autologous hematopoietic cell transplantation (AHCT) among patients with multiple myeloma (MM) and outcomes based on race/ethnicity in the United States. METHODS: The Center for International Blood and Marrow Transplant Research database was used to identify 28, 450 patients who underwent AHCT for MM from 2008 through 2014. By using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results 18 registries, the incidence of MM was calculated, and a stem cell transplantation utilization rate (STUR) was derived. Post‐AHCT outcomes were analyzed among patients ages 18 to 75 years who underwent melphalan‐conditioned peripheral cell grafts (N = 24, 102). RESULTS: The STUR increased across all groups from 2008 to 2014. The increase was substantially lower among Hispanics (range, 8.6%‐16.9%) and non‐Hispanic blacks (range, 12.2%‐20.5%) compared with non‐Hispanic whites (range, 22.6%‐37.8%). There were 18, 046 non‐Hispanic whites, 4123 non‐Hispanic blacks, and 1933 Hispanic patients. The Hispanic group was younger ( P < .001). Fewer patients older than 60 years underwent transplantation among Hispanics (39%) and non‐Hispanic blacks (42%) compared with non‐Hispanic whites (56%). A Karnofsky score <90% and a hematopoietic cell transplantation comorbidity index score >3 were more common in non‐Hispanic blacks compared with Hispanic and non‐Hispanic whites ( P < .001). More Hispanics (57%) versus non‐Hispanic blacks (54%) and non‐Hispanic whites (52%; P < .001) had stage III disease. More Hispanics (48%) versus non‐Hispanic blacks (45%) and non‐Hispanic whites (44%) had a very good partial response or better before transplantation ( P = .005). Race/ethnicity did not impact post‐AHCT outcomes. CONCLUSIONS: Although the STUR increased, it remained low and was significantly lower among Hispanics followed by non‐Hispanic blacks compared with non‐Hispanic whites. Race/ethnicity did not impact transplantation outcomes. Efforts to increase the rates of transplantation for eligible patients who have MM, with an emphasis on groups that underuse transplantation, are warranted. Cancer 2017;123:3141–9. © 2017 American Cancer Society . Abstract : The results from this investigation of the stem cell transplantation utilization rate across race/ethnicity in the United States indicate that, although the rate is increasing, it remains low and is significantly lower among Hispanics followed by non‐Hispanic blacks compared with non‐Hispanic whites. Race/ethnicity does not impact transplantation outcomes but remains a barrier to clinical care; and efforts are warranted to increase the use of transplantation for eligible patients who have multiple myeloma, with emphasis on groups that underuse transplantation. See also pages 3005‐6.