Access to hematopoietic stem cell transplantation

Effect of race and sex

Thomas Vayalinkara Joshua, J. Douglas Rizzo, Mei Jie Zhang, Parameswaran N. Hari, Seira Kurian, Marcelo Pasquini, Navneet S. Majhail, Stephanie J. Lee, Mary M. Horowitz

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

BACKGROUND: The purpose of the current study was to determine whether the use of hematopoietic stem cell transplantation (HCT) to treat leukemia, lymphoma, or multiple myeloma (MM) differs by race and sex. METHODS: The annual incidence of leukemia, lymphoma, and MM was estimated in the United States in people aged <70 years by race and sex using the Surveillance, Epidemiology, and End Results (SEER) cancer registry between 1997 and 2002 and US census reports for the year 2000. The annual incidence of autologous, human leukocyte antigen (HLA) identical sibling, and unrelated HCT performed in these groups was estimated using Center for International Blood and Marrow Transplant Research data from 1997 through 2002. Logistic regression analysis was used to calculate the age-adjusted odds ratio (OR) of receiving HCT for Caucasians versus African Americans and for men versus women. RESULTS: The likelihood of undergoing HCT was found to be higher for Caucasians than for African Americans (OR, 1.40; 95% confidence interval [95% CI], 1.34-1.46). This difference existed for each type of HCT: autologous (OR, 1.24; 95% CI, 1.19-1.30), HLA identical sibling (OR, 1.59; 95% CI, 1.46-1.74), and unrelated donor (OR, 2.02; 95% CI, 1.75-2.33). Overall, men were more likely than women to receive HCT (OR, 1.07; 95% CI, 1.05-1.1 [P < .0001]); however, this difference was found to be significant only for autologous HCT (OR, 1.10; 95% CI, 1.07-1.13 [P < .0001]). CONCLUSIONS: HCT is more frequently used to treat leukemia, lymphoma, and MM in Caucasians than in African American individuals. African Americans have lower rates of both autologous and allogeneic HCT, indicating that donor availability cannot fully explain the differences. Women are less likely than men to receive autologous HCT for reasons unexplained by age or disease status.

Original languageEnglish (US)
Pages (from-to)3469-3476
Number of pages8
JournalCancer
Volume116
Issue number14
DOIs
StatePublished - Jul 15 2010

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Hematopoietic Stem Cell Transplantation
Odds Ratio
Confidence Intervals
African Americans
Multiple Myeloma
Lymphoma
Leukemia
HLA Antigens
Siblings
Unrelated Donors
Incidence
Censuses
Registries
Epidemiology
Logistic Models
Bone Marrow
Regression Analysis
Tissue Donors
Transplants

Keywords

  • Access to care
  • Effect of race and sex
  • Hematopoietic stem cell transplantation
  • Leukemia
  • Lymphoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Joshua, T. V., Rizzo, J. D., Zhang, M. J., Hari, P. N., Kurian, S., Pasquini, M., ... Horowitz, M. M. (2010). Access to hematopoietic stem cell transplantation: Effect of race and sex. Cancer, 116(14), 3469-3476. https://doi.org/10.1002/cncr.25297

Access to hematopoietic stem cell transplantation : Effect of race and sex. / Joshua, Thomas Vayalinkara; Rizzo, J. Douglas; Zhang, Mei Jie; Hari, Parameswaran N.; Kurian, Seira; Pasquini, Marcelo; Majhail, Navneet S.; Lee, Stephanie J.; Horowitz, Mary M.

In: Cancer, Vol. 116, No. 14, 15.07.2010, p. 3469-3476.

Research output: Contribution to journalArticle

Joshua, TV, Rizzo, JD, Zhang, MJ, Hari, PN, Kurian, S, Pasquini, M, Majhail, NS, Lee, SJ & Horowitz, MM 2010, 'Access to hematopoietic stem cell transplantation: Effect of race and sex', Cancer, vol. 116, no. 14, pp. 3469-3476. https://doi.org/10.1002/cncr.25297
Joshua TV, Rizzo JD, Zhang MJ, Hari PN, Kurian S, Pasquini M et al. Access to hematopoietic stem cell transplantation: Effect of race and sex. Cancer. 2010 Jul 15;116(14):3469-3476. https://doi.org/10.1002/cncr.25297
Joshua, Thomas Vayalinkara ; Rizzo, J. Douglas ; Zhang, Mei Jie ; Hari, Parameswaran N. ; Kurian, Seira ; Pasquini, Marcelo ; Majhail, Navneet S. ; Lee, Stephanie J. ; Horowitz, Mary M. / Access to hematopoietic stem cell transplantation : Effect of race and sex. In: Cancer. 2010 ; Vol. 116, No. 14. pp. 3469-3476.
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abstract = "BACKGROUND: The purpose of the current study was to determine whether the use of hematopoietic stem cell transplantation (HCT) to treat leukemia, lymphoma, or multiple myeloma (MM) differs by race and sex. METHODS: The annual incidence of leukemia, lymphoma, and MM was estimated in the United States in people aged <70 years by race and sex using the Surveillance, Epidemiology, and End Results (SEER) cancer registry between 1997 and 2002 and US census reports for the year 2000. The annual incidence of autologous, human leukocyte antigen (HLA) identical sibling, and unrelated HCT performed in these groups was estimated using Center for International Blood and Marrow Transplant Research data from 1997 through 2002. Logistic regression analysis was used to calculate the age-adjusted odds ratio (OR) of receiving HCT for Caucasians versus African Americans and for men versus women. RESULTS: The likelihood of undergoing HCT was found to be higher for Caucasians than for African Americans (OR, 1.40; 95{\%} confidence interval [95{\%} CI], 1.34-1.46). This difference existed for each type of HCT: autologous (OR, 1.24; 95{\%} CI, 1.19-1.30), HLA identical sibling (OR, 1.59; 95{\%} CI, 1.46-1.74), and unrelated donor (OR, 2.02; 95{\%} CI, 1.75-2.33). Overall, men were more likely than women to receive HCT (OR, 1.07; 95{\%} CI, 1.05-1.1 [P < .0001]); however, this difference was found to be significant only for autologous HCT (OR, 1.10; 95{\%} CI, 1.07-1.13 [P < .0001]). CONCLUSIONS: HCT is more frequently used to treat leukemia, lymphoma, and MM in Caucasians than in African American individuals. African Americans have lower rates of both autologous and allogeneic HCT, indicating that donor availability cannot fully explain the differences. Women are less likely than men to receive autologous HCT for reasons unexplained by age or disease status.",
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AU - Kurian, Seira

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N2 - BACKGROUND: The purpose of the current study was to determine whether the use of hematopoietic stem cell transplantation (HCT) to treat leukemia, lymphoma, or multiple myeloma (MM) differs by race and sex. METHODS: The annual incidence of leukemia, lymphoma, and MM was estimated in the United States in people aged <70 years by race and sex using the Surveillance, Epidemiology, and End Results (SEER) cancer registry between 1997 and 2002 and US census reports for the year 2000. The annual incidence of autologous, human leukocyte antigen (HLA) identical sibling, and unrelated HCT performed in these groups was estimated using Center for International Blood and Marrow Transplant Research data from 1997 through 2002. Logistic regression analysis was used to calculate the age-adjusted odds ratio (OR) of receiving HCT for Caucasians versus African Americans and for men versus women. RESULTS: The likelihood of undergoing HCT was found to be higher for Caucasians than for African Americans (OR, 1.40; 95% confidence interval [95% CI], 1.34-1.46). This difference existed for each type of HCT: autologous (OR, 1.24; 95% CI, 1.19-1.30), HLA identical sibling (OR, 1.59; 95% CI, 1.46-1.74), and unrelated donor (OR, 2.02; 95% CI, 1.75-2.33). Overall, men were more likely than women to receive HCT (OR, 1.07; 95% CI, 1.05-1.1 [P < .0001]); however, this difference was found to be significant only for autologous HCT (OR, 1.10; 95% CI, 1.07-1.13 [P < .0001]). CONCLUSIONS: HCT is more frequently used to treat leukemia, lymphoma, and MM in Caucasians than in African American individuals. African Americans have lower rates of both autologous and allogeneic HCT, indicating that donor availability cannot fully explain the differences. Women are less likely than men to receive autologous HCT for reasons unexplained by age or disease status.

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