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Impact of race and ethnicity on outcomes and health care utilization after allogeneic hematopoietic cell transplantation.

Research paper by Nandita N Khera, Yu-Hui YH Chang, James J Slack, Veena V Fauble, Jose F JF Leis, Pierre P Noel, Lisa L Sproat, Jeanne J Palmer, Roberta R Adams, Tom T Fitch, Donald D Northfelt, Mignonne M Guy, Jon J Tilburt, Joseph J Mikhael

Indexed on: 12 Jul '14Published on: 12 Jul '14Published in: Leukemia & lymphoma



Abstract

Disparities in outcomes after hematopoietic cell transplant (HCT) are reported mostly by registry studies. We examined the association of self-reported race and ethnicity with outcomes and health care utilization after allogeneic HCT in a single center study. Clinical and socioeconomic data of 296 adult patients who underwent allogeneic HCT from November 2003 to October 2012 were analyzed. Survival was compared between non-Hispanic Whites (NHW) and minority patients using Cox proportional hazards regression. Some 73% of patients were NHW and 27% were racial/ethnic minority patients. More minority patients were younger and had lower socioeconomic status. Both unadjusted and adjusted overall and progression-free survival were comparable between the two groups. High risk disease, poor performance score and Medicare/Tricare were significant predictors of mortality. Health care utilization was comparable between the two groups. Homogeneity of medical care for allogeneic HCT may help overcome racial/ethnic disparities, but not those due to patients' primary insurance.