Background: Clinical outcome disparities among racial and ethnic groups have been described following allogeneic hematopoietic cell transplantation (HCT). This study investigated the impact of race and ethnicity on HCT outcomes in a multi-ethnic single-center population. Methods: We analyzed outcomes of 709 allogeneic HCT patients, stratified by racial and ethnic groups, who underwent allogeneic HCT between January 2018 and April 2022. Outcomes examined included overall survival (OS), cumulative incidence of relapse (CIR), non-relapse mortality (NRM), and graft-versus-host disease/relapse-free survival (GRFS). Results: No significant differences in OS, CIR, NRM, GRFS, acute GVHD (aGVHD), or chronic GVHD (cGVHD) were observed. Significant differences in age, use of human leukocyte antigen-mismatched donors (HLA-MM), and HCT-CI comorbidity scores ≥ 3 across racial and ethnic groups were observed. Overall mean age was 58 years, with Black patients having the youngest mean age of 43 (range 22–73) and White patients the highest mean age of 59 (range 18–76) (p< 0.001). HCT-CI score ≥ 3 was seen in 35.9% of the entire cohort, varying by race and ethnicity: 60.5% in Black, 41.4% in South Asian, 31.5% in White, and 29.0% in East Asian patients (p< 0.001). Utilization of HLA-MM donors (including haploidentical) was 29.2% overall, with highest frequencies in Black (65.1%) and East Asian (45%) patients, and lowest in White patients (20.4%) (p< 0.001). Conclusions: Statistically significant differences were observed across self-identified racial and ethnic groups regarding age, HCT-CI ≥ 3, and the use of HLA-MM donors. However, post-allogeneic HCT outcomes did not differ significantly by race or ethnicity. Larger prospective trials are warranted to validate our findings.
背景：已有研究报道异基因造血细胞移植（HCT）后不同种族和民族群体间的临床结局存在差异。本研究旨在探讨多民族单中心人群中种族和民族对HCT结局的影响。方法：我们分析了2018年1月至2022年4月期间接受异基因HCT的709例患者，按种族和民族分层。评估的结局指标包括总生存期（OS）、累积复发率（CIR）、非复发死亡率（NRM）以及移植物抗宿主病/无复发生存期（GRFS）。结果：在OS、CIR、NRM、GRFS、急性GVHD（aGVHD）或慢性GVHD（cGVHD）方面均未观察到显著差异。但不同种族和民族群体在年龄、人类白细胞抗原不匹配供者（HLA-MM）使用率以及HCT-CI合并症评分≥3方面存在显著差异。总体平均年龄为58岁，其中黑人患者平均年龄最低（43岁，范围22-73岁），白人患者平均年龄最高（59岁，范围18-76岁）（p<0.001）。全队列中35.9%的患者HCT-CI评分≥3，不同种族和民族间存在差异：黑人患者为60.5%，南亚患者为41.4%，白人患者为31.5%，东亚患者为29.0%（p<0.001）。HLA-MM供者（包括单倍体相合）使用率总体为29.2%，其中黑人（65.1%）和东亚患者（45%）使用率最高，白人患者（20.4%）最低（p<0.001）。结论：不同自我认同的种族和民族群体在年龄、HCT-CI≥3以及HLA-MM供者使用率方面存在统计学显著差异。然而，异基因HCT后的临床结局并未因种族或民族不同而产生显著差异。需要更大规模的前瞻性试验来验证我们的发现。
Exploring Outcomes by Ethnicity in Allogeneic Hematopoietic Cell Transplantation
肿瘤(癌症)患者之家