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

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

Research output: Contribution to journalArticle

2 Citations (Scopus)

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

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Cell Transplantation
Acute Myeloid Leukemia
Health
Educational Status
Insurance Coverage
Medicaid
Medicare
Insurance
Comorbidity
Logistic Models
Regression Analysis
Databases
Survival

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Socioeconomic and health system factors associated with lower utilization of hematopoietic cell transplantation in older patients with acute myeloid leukemia. / Bhatt, Vijaya R; Chen, Baojiang; Gyawali, Bishal; Lee, Stephanie J.

In: Bone marrow transplantation, Vol. 53, No. 10, 01.10.2018, p. 1288-1294.

Research output: Contribution to journalArticle

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