Multiple myeloma (MM) therapeutics have evolved tremendously in recent years, with significant improvement in patient outcomes. As newer treatment options are developed, stem cell transplant (SCT) remains an important modality that provides excellent disease control and delays the progression of disease. Over the years, SCT use has increased overall in the U.S., but two distinct gaps remain, including suboptimal use overall and racial-ethnic disparities. We evaluated the National Cancer Database (NCDB) to study what sociodemographic factors might play a role within a given racial-ethnic group leading to disparate SCT utilization, such that targeted approaches can be developed to optimize SCT use for all. In nearly 112,000 cases belonging to mutually exclusive categories of non-Hispanic Whites (NHW), non-Hispanic Blacks (NHB), Hispanics, non-Hispanic Asians (NHA), and others, we found certain factors including age, comorbidity index, payor type, facility type (academic vs. community) and facility volume to be uniformly associated with SCT use for all the racial-ethnic groups, while gender was not significant for any of the groups. There were several other factors that had a differential impact on SCT utilization among the various race-ethnicity groups studied, including year of diagnosis (significant for NHW, NHB, and Hispanics), income level (significant for NHW and Hispanics), literacy level (significant for NHW and NHB), and geographic location of the treatment facility (significant for NHW and NHA). The suboptimal SCT utilization overall in the U.S. suggests that there may be room for improvement for all, even including the majority NHW, while we continue to work on factors that lead to disparities for the traditionally underserved populations. This study helps identify sociodemographic factors that may play a role specifically in each group and paves the way to devise targeted solutions such that resource utilization and impact can be maximized.
近年来，多发性骨髓瘤（MM）治疗手段取得了巨大进展，患者预后显著改善。随着新治疗方案的开发，干细胞移植（SCT）仍然是一种重要的治疗方式，能提供优异的疾病控制并延缓疾病进展。多年来，干细胞移植（SCT）在美国的使用总体增加，但仍存在两个明显的差距，包括总体使用不足和种族-民族差异。我们评估了国家癌症数据库（NCDB），以研究在特定种族-民族群体中，哪些社会人口学因素可能导致干细胞移植（SCT）利用率的差异，从而可以制定针对性方法以优化所有人的SCT使用。在近112,000例属于互斥类别的非西班牙裔白人（NHW）、非西班牙裔黑人（NHB）、西班牙裔、非西班牙裔亚裔（NHA）及其他群体的病例中，我们发现某些因素，包括年龄、合并症指数、支付方类型、机构类型（学术型 vs. 社区型）和机构病例量，与所有种族-民族群体的SCT使用均相关，而性别对任何群体均不显著。还有其他几个因素对所研究的不同种族-民族群体的SCT利用率有差异性影响，包括诊断年份（对NHW、NHB和西班牙裔显著）、收入水平（对NHW和西班牙裔显著）、文化水平（对NHW和NHB显著）以及治疗机构的地理位置（对NHW和NHA显著）。美国总体SCT使用不足表明，所有人都有改进空间，甚至包括占多数的NHW，而我们继续致力于解决导致传统服务不足人群差异的因素。本研究有助于识别可能在每个群体中具体起作用的社会人口学因素，并为设计针对性解决方案铺平道路，从而最大化资源利用和影响。
肿瘤(癌症)患者之家