Whites more likely than blacks to receive HSCT

Whites are more likely to undergo hematopoietic stem cell transplantation for leukemia, lymphoma or multiple myeloma when compared with blacks, regardless of the type of transplantation.

Previous research has indicated that differences in health care disparities exist across race and sex. Therefore, researchers set out to determine whether the use of hematopoietic stem cell transplantation (HSCT) for the treatment of leukemia, lymphoma or multiple myeloma differed according to race or sex among 27,725 people aged younger than 70 years.

Data were pooled from the SEER Cancer Registry between 1997 and 2002 and from the U.S. Census Reports for 2000. In addition, data on the annual incidence of autologous, human leukocyte antigen (HLA) identical sibling and unrelated HSCT use was obtained from the Center for International Blood and Marrow Transplant Research between 1997 and 2002.

Fifty-five percent of the study population underwent autologous HSCT: 21% underwent HLA identical sibling HSCT and 24% underwent unrelated donor HSCT. Ninety percent of patients were white and only 10% were black; about 59% were men.

The likelihood of undergoing HSCT was increased among whites (OR=1.40; 95% CI, 1.34-1.46). Moreover, this difference was increased for each type of HSCT: 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 HSCT (OR=1.07; 95% CI, 1.05-1.1; P<.0001). However, the difference was only significant for autologous HSCT (OR=1.10; 95% CI, 1.07-1.13; P<.0001). Further, men were more likely than women to undergo HLA HSCT for multiple myeloma and non-Hodgkin’s lymphoma.

“This study helps us understand that in general, access to HSCT in the United States is not equal, with [blacks] and women being less likely to be treated for the most common indications,” J. Douglas Rizzo, MD, MS, of the Center for International Blood and Marrow Transplant Research at the Medical College of Wisconsin, said in a press release.

“Although the reason for this gap cannot be explained by this study, it suggests that the health care system in the United States should endeavor to improve access for all patients while waiting for further studies to better explain the differences and suggest better strategies to reduce the disparities.”

The researchers suggested for additional research to determine why disparities exist in access to transplantation and also that the medical community should work to eliminate these inequities.

Joshua TV. Cancer. 2010;doi:10.1002/cncr.25297.