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Socioeconomic and health system factors associated with lower utilization of hematopoietic cell transplantation in older patients with acute myeloid leukemia.

Abstract：

:Receipt of hematopoietic cell transplantation (HCT) can improve overall survival in older patients with intermediate or high-risk acute myeloid leukemia (AML); however, utilization of HCT is poor. It is important to understand the factors that affect the receipt of HCT in a real-world setting among the older patients. We utilized the National Cancer Database to determine receipt of HCT in older patients (61-75 years) with intermediate or high-risk AML reported between 2003 and 2012. Multivariate logistic regression analysis was used to determine factors associated with receipt of HCT. Only 5.5% of older patients (n = 17,555) underwent HCT. Factors associated with a lower likelihood of receiving HCT included receipt of care in a non-academic hospital, race other than white, older age, Charlson comorbidity score of ≥1, uninsured status, Medicaid or Medicare insurance, and lower educational status. The receipt of HCT in older patients is low and varies based on biological as well as non-biologic factors, such as hospital type, insurance, and educational status. Nationwide efforts to improve access to HCT for appropriate patients are necessary.

journal_name

Bone Marrow Transplant

journal_title

Bone marrow transplantation

authors

Bhatt VR,Chen B,Gyawali B,Lee SJ

doi

10.1038/s41409-018-0164-y

subject

Has Abstract

pub_date

2018-10-01 00:00:00

pages

1288-1294

issue

10

eissn

0268-3369

issn

1476-5365

pii

10.1038/s41409-018-0164-y

journal_volume

53

pub_type

杂志文章

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