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Use of hematopoietic cell transplantation in younger patients with acute myeloid leukemia: A National Cancer Database Study

Bone Marrow Transplantation volume 53, pages 873–879 (2018)Cite this article

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Abstract

Younger patients with intermediate or high-risk acute myeloid leukemia (AML) obtain overall survival benefit from the upfront use of hematopoietic cell transplantation (HCT). We queried the National Cancer Database to study 19,897 younger patients (18–60 years) with intermediate or high-risk AML reported between 2003–2012. Multivariable logistic regression analysis was performed to identify variables associated with the utilization of HCT. Approximately 18.5% of younger patients received HCT as a part of initial therapy. A lower rate of utilization of HCT was associated with receipt of care in a non-academic hospital, African American race, male sex, age group 50–60 years, Charlson comorbidity score of ≥1, uninsured status, Medicaid or Medicare insurance, and lower educational or income status. The use of HCT in younger patients varies based on non-biologic factors such as race, hospital type, insurance, educational, and income status. Socioeconomic and health system factors contribute to disparity in the uptake of HCT in the US.

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Acknowledgements

Vijaya Bhatt is supported by 2016–2017 Physician-Scientist Training Program Grant from the College of Medicine, University of Nebraska Medical Center. The National Cancer Data Base (NCDB) is a joint project of the Commission on Cancer (CoC) of the American College of Surgeons and the American Cancer Society. The CoC’s NCDB and the hospitals participating in the CoC NCDB are the source of the de-identified data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.

Author contributions

VRB and SJL developed the concept and design of the study. VRB and BC were involved with data analysis. All authors contributed to the interpretation of the results. The initial manuscript was drafted by VRB. All authors reviewed and critically revised the manuscript. All the authors approved the final version of the manuscript.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Hematology-Oncology, University of Nebraska Medical Center, Omaha, NE, USA

    Vijaya Raj Bhatt

  2. Department of Biostatistics, University of Texas Health Science Center at Houston, School of Public Health, Austin Regional Campus, Austin, TX, USA

    Baojiang Chen

  3. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Stephanie J. Lee

Authors
  1. Vijaya Raj Bhatt
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  2. Baojiang Chen
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  3. Stephanie J. Lee
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Corresponding author

Correspondence to Vijaya Raj Bhatt.

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The authors declare that they have no conflict of interest.

Additional information

The abstract of this paper was published online as a proceeding of 2016 American Society of Clinical Oncology annual meeting held in Chicago from June 3–7, 2016.

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Bhatt, V.R., Chen, B. & Lee, S.J. Use of hematopoietic cell transplantation in younger patients with acute myeloid leukemia: A National Cancer Database Study. Bone Marrow Transplant 53, 873–879 (2018). https://doi.org/10.1038/s41409-018-0105-9

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