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

Vijaya Raj Bhatt, Baojiang Chen, Bishal Gyawali, Stephanie J. Lee

Research output: Contribution to journalArticle

5 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1288-1294
Number of pages7
JournalBone marrow transplantation
Volume53
Issue number10
DOIs
StatePublished - Oct 1 2018

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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