Socio-demographic characteristics of patients with hematologic malignancies referred to the National Institutes of Health (NIH) for Hematopoietic Cell Transplant (HCT): a retrospective study of patient barriers to HCT access

Authors

• CA Eleanya
• SL Doran
• AH Chai
• RM Schwartz
• JR Andrade
• D Dimitrova
• J Hendricks
• MA Hyder
• KA Rechache
• RS Sabina
• JM Sponaugle
• CG Kanakry
• JA Kanakry

Abstract

Background: HCT is a potential cure for many hematologic malignancies. Understanding barriers to HCT access can help address cancer care disparities. Multiple socio-demographic characteristics have been associated with decreased HCT access. This study aims to characterize the socio-demographic factors of patients who successfully underwent HCT at the NIH.

Methods: We conducted a retrospective study of patients with hematologic malignancies referred to the NIH between 1/1/20-12/31/22. Data were analyzed using descriptive statistics and GraphPad Prism.

Results: Out of 331 referrals during the study period, 240 (72%) were sufficiently engaged to receive a medical record number (MRN) and 87 (26%) reached HCT. Of the 91 without an MRN, 40% were in 2020, 36% in 2021, and 24% in 2022. Among the 240 with an MRN, 148 were male and 92 were female, with similar rates of HCT (35% and 37%). The referral pool included Hispanic (53%), non-Hispanic White (24%), and Black (14%) patients. 41% of Black, 39% of Hispanic, and 30% of non-Hispanic White patients reached HCT; 55% of non-English speaking patients reached HCT. Median time from referral to HCT was 137 days (range: 32-1377 days). This time was significantly longer for non-English speaking patients (191 days vs 116 days; p=0.0014) and for single/divorced patients (163 days vs 127 days; p=0.04).

Conclusion: Only 26% of referred patients underwent HCT, with a higher early disengagement rate in 2020. Successful referrals did not differ by race/ethnicity, sex, or marital status. Time from referral to HCT was faster for married and English-speaking patients.

Scientific Focus Area: Health Disparities

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