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Related Concept Videos

Regulation of Hematopoietic Stem Cells01:01

Regulation of Hematopoietic Stem Cells

All blood and immune cells are produced from the multipotent hematopoietic stem cells (HSCs) by the process of hematopoiesis. However, they all have a limited life span. In addition, many are depleted in immune surveillance or combatting an injury or infection. This makes blood one of the most regenerative tissues. Hematopoiesis helps replenish these blood and immune cells, restoring the body's normal functioning. However, overproduction of blood and immune cells can make them cancerous or...
Bone Marrow Sampling and Transplants01:22

Bone Marrow Sampling and Transplants

Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy the...

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Adverse Social Determinants Independently Predict Outcomes After Allogeneic HSCT.

Maria Huguet1, Mireia Morgades1, Mercè Riquelme-Olivares2

  • 1Hematology Department, ICO Badalona, Germans Trias i Pujol University Hospital, Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona. Josep Carreras Leukaemia Research Institute, Barcelona, Spain.

Transplantation and Cellular Therapy
|March 26, 2026
PubMed
Summary

Adverse social determinants significantly worsen outcomes after allogeneic stem cell transplants. Identifying and addressing social risks is crucial for improving survival and reducing complications in transplant patients.

Keywords:
Allogeneic HSCTGraft-versus-host diseaseHealth disparitiesNonrelapse mortalitySocial determinants of health

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Area of Science:

  • Hematology
  • Transplant Immunology
  • Public Health

Background:

  • Allogeneic hematopoietic stem cell transplantation (HSCT) offers curative potential for hematologic diseases.
  • However, HSCT is linked to significant morbidity and non-relapse mortality (NRM).
  • The influence of adverse social determinants on HSCT outcomes in universal healthcare systems requires further investigation.

Purpose of the Study:

  • To investigate the association between adverse social determinants and outcomes following allogeneic HSCT.
  • To assess the impact of social factors on overall survival, NRM, GVHD, and mortality causes.

Main Methods:

  • Retrospective single-center cohort study of 286 adult HSCT recipients (2012-2022).
  • Assessed baseline social determinants: communication barriers, financial hardship, and living alone.
  • Analyzed overall survival (OS), NRM, GVHD, and cause-specific mortality using multivariable models.

Main Results:

  • Presence of at least one adverse social determinant independently predicted inferior OS (HR 2.39) and higher NRM (HR 2.68).
  • A dose-response relationship was observed between the number of adverse factors and poorer outcomes.
  • Patients with social disadvantages experienced higher rates of acute and chronic GVHD and increased infection-related deaths.

Conclusions:

  • Adverse social determinants are independently linked to worse survival, increased GVHD, and higher NRM post-allogeneic HSCT.
  • Social disadvantage significantly impacts transplant outcomes, even within universal healthcare settings.
  • Systematic identification of social risks and targeted interventions are essential for improving patient care.