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在多发性骨髓瘤中随着时间的推移利用自身造血细胞移植:基于人口的研究

Naseem S Esteghamat¹, Ann Brunson², Aaron S Rosenberg¹

¹Division of Malignant Hematology, Cellular Therapy and Transplantation, University of California Davis Comprehensive Cancer Center, Sacramento, CA.

Clinical lymphoma, myeloma & leukemia

|January 9, 2024

概括

自主造血细胞移植 (autoHCT) 在多发性骨髓瘤的使用增加,但保险,种族和社会经济地位的差异仍然存在. 解决这些障碍对于公平获得这种救命治疗至关重要.

科学领域:

血液学血液学血液学
在瘤学瘤学.
公共卫生公共卫生

背景情况:

自主造血细胞移植 (autoHCT) 为多发性骨髓瘤 (MM) 提供了生存益处.
目前的自动HCT利用率低于最佳,并且在各个社会人口群体之间存在很大差异.
之前的研究还没有全面评估基于人口的AutoHCT趋势及其随着时间推移与人口因素的关系.

研究的目的:

分析1991年至2016年加利福尼亚州多发性骨髓瘤 (MM) 患者自动HCT利用趋势.
识别与随着时间的推移使用自动HCT相关的社会人口因素.
根据保险状况,种族/种族和社会经济状况,检查获得自动HCT的差异.

主要方法:

利用来自加利福尼亚癌症登记处,国际血液和骨髓移植研究中心以及住院记录的链接数据.
分析了1991年至2016年间诊断的29,109名MM患者的基于人口的队列.
采用分层多变量Cox比例危险回归模型来确定与自动HCT相关的因素,并考虑治疗时代的相互作用.

主要成果:

在MM患者中AutoHCT的利用率从5.7% (1991-1995) 增加到27.4% (2011-2016).
公共/无保险的患者,黑人/非裔美国患者和西班牙裔患者 (特别是在早期) 接受自动HCT的可能性较低.
较低的社会经济地位与减少的自动HCT使用有关,尽管这种差异随着时间的推移而减少.

结论:

尽管对MM的自动HCT使用量增加,但在接入方面仍然存在显著的社会人口统计差异.
识别和解决对自动HCT的障碍对于确保这种有效疗法的公平应用至关重要.
需要进一步的研究和有针对性的干预措施,以促进所有MM患者公平获得autoHCT.

关键词:

成年人成年人成年人成年人成年人成年人多发性骨髓瘤是一种多发性骨髓瘤.移植移植移植移植

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