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Patient socioeconomic status as a prognostic factor for allo-SCT
1Department of Internal Medicine, Division of Hematology and Bone Marrow Transplantation, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil. lsilla@hcpa.ufrgs.br
Bone Marrow Transplantation
|November 4, 2008
Summary
Lower socioeconomic status (SeS) in Brazil is linked to worse outcomes in allogeneic stem cell transplants (allo-SCT), including higher graft-versus-host disease and transplant-related mortality, impacting overall survival.
Area of Science:
- Hematology
- Transplant Immunology
- Public Health
Background:
- Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a critical treatment for various hematologic malignancies.
- Socioeconomic status (SeS) can influence healthcare access and patient outcomes, but its impact on allo-SCT in Brazil is understudied.
Purpose of the Study:
- To evaluate the association between socioeconomic status and outcomes following allo-SCT in a Brazilian cohort.
- To identify specific transplant-related factors influenced by socioeconomic disparities.
Main Methods:
- Retrospective analysis of 201 patients undergoing HLA-identical related allo-SCT.
- Patients were stratified into socioeconomic groups (A-E) based on Brazilian market research classifications.
- Multivariate analysis was used to assess the impact of SeS on graft-versus-host disease (GVHD), engraftment, transplant-related mortality (TRM), and overall survival.
Main Results:
- Patients in lower socioeconomic groups (D+E) exhibited significantly higher incidences of acute and chronic GVHD (HR=2.61-2.62; P<0.001).
- Lower SeS was associated with improved platelet and neutrophil engraftment (HR=1.94-2.12; P<0.001) but also a higher TRM (HR=1.92; P=0.039).
- A lower SeS (D+E) was a significant predictor of worse overall survival at 5 years (HR=2.13; P=0.001).
Conclusions:
- Lower socioeconomic status is a significant negative prognostic factor in Brazilian patients undergoing allo-SCT.
- Socioeconomic disparities influence key outcomes including GVHD, engraftment, TRM, and overall survival post-transplant.
- Addressing socioeconomic factors may be crucial for improving allo-SCT outcomes in diverse populations.
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