Factors determining utilization of stem cell transplant for initial therapy of multiple myeloma by patient race: exploring intra-racial healthcare disparities

Factors determining utilization of stem cell transplant for initial therapy of multiple myeloma by patient race: exploring intra-racial healthcare disparities

Multiple myeloma (MM) therapeutics have evolved tremendously in recent years, with significant improvement in patient outcomes. As newer treatment options are developed, stem cell transplant (SCT) remains an important modality that provides excellent disease control and delays the progression of dis...

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Bibliographic Details
Published in:Blood cancer journal (New York) Vol. 14; no. 1; pp. 86 - 5
Main Authors: Ailawadhi, Sikander, Adu, Yaw, Frank, Ryan D., Das, Saurav, Hodge, David O., Fernandez, Andre, Flott, Caitlyn, Elliott, Jamie, Parrondo, Ricardo, Sher, Taimur, Roy, Vivek, Chanan-Khan, Asher A.
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 28-05-2024
Springer Nature B.V
Nature Publishing Group
Subjects:
631/532/1542
631/67/2324
692/699/1541/1990/804
692/700/478/174
692/700/784
Adult
Aged
Biomedical and Life Sciences
Biomedicine
Cancer Research
Female
Healthcare Disparities
Hematology
Hematopoietic Stem Cell Transplantation
Hispanic people
Humans
Male
Middle Aged
Multiple myeloma
Multiple Myeloma - epidemiology
Multiple Myeloma - therapy
Oncology
Race
Sociodemographics
Stem Cell Transplantation
United States - epidemiology
United States
United States > US
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Description
Summary:Multiple myeloma (MM) therapeutics have evolved tremendously in recent years, with significant improvement in patient outcomes. As newer treatment options are developed, stem cell transplant (SCT) remains an important modality that provides excellent disease control and delays the progression of disease. Over the years, SCT use has increased overall in the U.S., but two distinct gaps remain, including suboptimal use overall and racial-ethnic disparities. We evaluated the National Cancer Database (NCDB) to study what sociodemographic factors might play a role within a given racial-ethnic group leading to disparate SCT utilization, such that targeted approaches can be developed to optimize SCT use for all. In nearly 112,000 cases belonging to mutually exclusive categories of non-Hispanic Whites (NHW), non-Hispanic Blacks (NHB), Hispanics, non-Hispanic Asians (NHA), and others, we found certain factors including age, comorbidity index, payor type, facility type (academic vs. community) and facility volume to be uniformly associated with SCT use for all the racial-ethnic groups, while gender was not significant for any of the groups. There were several other factors that had a differential impact on SCT utilization among the various race-ethnicity groups studied, including year of diagnosis (significant for NHW, NHB, and Hispanics), income level (significant for NHW and Hispanics), literacy level (significant for NHW and NHB), and geographic location of the treatment facility (significant for NHW and NHA). The suboptimal SCT utilization overall in the U.S. suggests that there may be room for improvement for all, even including the majority NHW, while we continue to work on factors that lead to disparities for the traditionally underserved populations. This study helps identify sociodemographic factors that may play a role specifically in each group and paves the way to devise targeted solutions such that resource utilization and impact can be maximized.
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ISSN:2044-5385
2044-5385
DOI:10.1038/s41408-024-01067-x