ArticlePloS one2017
Sociodemographic disparities in chemotherapy and hematopoietic cell transplantation utilization among adult acute lymphoblastic and acute myeloid leukemia patients.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Systematic review of neighborhood socioeconomic indices studied across the cancer control continuum.Cancer medicine · 2022Pooled it
- Barriers to Hematopoietic Cell Transplantation for Adults in the United States: A Systematic Review with a Focus on Age.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2020Pooled it
- Article
- Access Challenges in Allogeneic Hematopoietic Cell Transplant: Identifying At-Risk US States by Exploring Social Vulnerability, Physician Density, and Unmet Need.JCO oncology practice · 2026Article
- Factors Associated with Receipt of Allogeneic Hematopoietic Cell Transplant and NMDP Donor Search in Older Adults with Acute Myeloid Leukemia.Transplantation and cellular therapy · 2026Article
- Socioeconomic disparities in glioma outcomes: a grade-specific analysis.Journal of neuro-oncology · 2026Article
- The global epidemiology of acute myeloid leukaemia.Nature reviews. Clinical oncology · 2026Review
- Assessing Social Determinants of Health in Transplantation and CAR-T Recipients: Expert Panel Recommendations from the Survivorship Special Interest Group of ASTCT.Transplantation and cellular therapy · 2025Review
- The Caregiver Paradigm in Hematopoietic Cell Transplant: Current and Future Directions.Transplantation and cellular therapy · 2025Review
- Observational
- Real-world treatment outcomes from a retrospective cohort of patients with acute myeloid leukemia from an urban safety net hospital.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2025Article
- Article
- Access to Transplant Care and Social Determinants of Health.Advances in experimental medicine and biology · 2025Review
- Existing Health Inequities in the Treatment of Advanced and Metastatic Cancers.Current oncology reports · 2024Review
- Multiomic profiling identifies predictors of survival in African American patients with acute myeloid leukemia.Nature genetics · 2024Article
- Differences in Acute Graft-Versus-Host Disease (GVHD) Severity and Its Outcomes Between Black and White Patients.Transplantation and cellular therapy · 2024Article
- Trends in volumes and survival after hematopoietic cell transplantation in racial/ethnic minorities.Blood advances · 2024Observational
- Article
- Hematopoietic Stem-Cell Transplantation: Exploring the Latest Advances and Gaps in Disparities, Psychosocial and Symptom Management Interventions, and Chronic Graft-Versus-Host Disease Care.American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting · 2024Review
- Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIdentifying sociodemographic disparities in chemotherapy and hematopoietic cell transplantation (HCT) utilization for acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) may improve survival for underserved populations. In this study, we incorporate neighborhood socioeconomic status (nSES), marital status, and distance from transplant center with previously studied factors to provide a comprehensive analysis of sociodemographic factors influencing treatments for ALL and AML.
methodsUsing the California Cancer Registry, we performed a retrospective, population-based study of patients ≥15 years old with ALL (n = 3,221) or AML (n = 10,029) from 2003 through 2012. The effect of age, sex, race/ethnicity, marital status, nSES, and distance from nearest transplant center on receiving no treatment, chemotherapy alone, or chemotherapy then HCT was analyzed.
resultsNo treatment, chemotherapy alone, or chemotherapy then HCT were received by 11%, 75%, and 14% of ALL patients and 36%, 53%, and 11% of AML patients, respectively. For ALL patients ≥60 years old, HCT utilization increased from 5% in 2005 to 9% in 2012 (p = 0.03). For AML patients ≥60 years old, chemotherapy utilization increased from 39% to 58% (p<0.001) and HCT utilization from 5% to 9% from 2005 to 2012 (p<0.001). Covariate-adjusted analysis revealed decreasing relative risk (RR) of chemotherapy with increasing age for both ALL and AML (trend p <0.001). Relative to non-Hispanic whites, lower HCT utilization occurred in Hispanic [ALL, RR = 0.80 (95% CI = 0.65-0.98); AML, RR = 0.86 (95% CI = 0.75-0.99)] and non-Hispanic black patients [ALL, RR = 0.40 (95% CI = 0.18-0.89); AML, RR = 0.60 (95% CI = 0.44-0.83)]. Compared to married patients, never married patients had a lower RR of receiving chemotherapy [ALL, RR = 0.96 (95% CI = 0.92-0.99); AML, RR = 0.94 (95% CI = 0.90-0.98)] or HCT [ALL, RR = 0.58 (95% CI = 0.47-0.71); AML, RR = 0.80 (95% CI = 0.70-0.90)]. Lower nSES quintiles predicted lower chemotherapy and HCT utilization for both ALL and AML (trend p <0.001).
conclusionsOlder age, lower nSES, and being unmarried predicted lower utilization of chemotherapy and HCT among ALL and AML patients whereas having Hispanic or black race/ethnicity predicted lower rates of HCT. Addressing these disparities may increase utilization of curative therapies in underserved acute leukemia populations.
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