Journal article
Association between sociodemographic and clinical factors and utilization of hematopoietic cell transplant in acute myeloid leukemia from 2004 to 2020
Cancer epidemiology, Vol.99, 102952
12/2025
DOI: 10.1016/j.canep.2025.102952
PMID: 41176871
Abstract
This study investigates the influence of sociodemographic and clinical factors on the utilization of hematopoietic cell transplant (HCT) in patients with acute myeloid leukemia (AML) between 2004 and 2020.
Patients identified from the National Cancer Database were grouped into two cohorts (2004–2010 and 2011–2019) to assess HCT trends. An additional analysis was conducted for 2020 to characterize HCT use after the onset of the COVID-19 pandemic. Logistic regression and multivariable analysis were used to estimate the influence of patient characteristics on the odds of receiving HCT.
Among 67,895 AML patients, 6968 (10.3 %) underwent HCT, with usage rising from 7.2 % in 2004–13.4 % in 2019. There was a notable increase in HCT utilization among patients > 70 years (0.4 % in 2004–2010–2.5 % in 2011–2019), Black patients (4.6–7.7 %), those with public insurance (3.2–6.2 %), and individuals with higher Charlson Comorbidity Index (CCI 1: 5.3–8.2 %; CCI 2–3: 1.9–4.8 %). Younger patients exhibited a higher likelihood of receiving HCT, with usage declining significantly with age and increasing CCI. Key factors such as race, education, income, insurance status, and AML subtype were significantly associated with HCT utilization (p < 0.01). Remarkably, HCT utilization for AML remained stable at 13.1 % in 2020 amid COVID-19 pandemic, comparable to 2019.
The rate of HCT utilization has continued to increase over time, with notable positive trends across various demographic groups. Despite this, substantial barriers related to sociodemographic and clinical factors hinder equitable treatment access, highlighting urgent need to address these inequities to enhance patient outcomes.
•HCT use has risen among older, Black, and publicly insured patients, and those with higher comorbidity.•Racial gaps in HCT access persist despite increased use among Black patients.•HCT use for AML stayed steady during the COVID-19 pandemic.•Assessments of sociodemographic and clinical factors can support more equitable and tailored AML treatment plans.
Details
- Title: Subtitle
- Association between sociodemographic and clinical factors and utilization of hematopoietic cell transplant in acute myeloid leukemia from 2004 to 2020
- Creators
- Utsav Joshi - Moffitt Cancer CenterAditya Ravindra - University of IowaBradley Loeffler - University of IowaUttam Bhetuwal - Rhode Island HospitalShishir Acharya - Department of Medicine, Chautara Hospital, Sindhupalchowk, NepalChengu Niu - Rochester General HospitalAvantika Pyakuryal - Pokhara UniversityVijaya Raj Bhatt - University of Nebraska Medical CenterPrajwal Dhakal - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Cancer epidemiology, Vol.99, 102952
- DOI
- 10.1016/j.canep.2025.102952
- PMID
- 41176871
- NLM abbreviation
- Cancer Epidemiol
- ISSN
- 1877-7821
- eISSN
- 1877-783X
- Publisher
- Elsevier Ltd
- Language
- English
- Date published
- 12/2025
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9985024250602771
Metrics
7 Record Views