Access to hematopoietic stem cell transplantation: effect of race and sex.
Access to hematopoietic stem cell transplantation: effect of race and sex.
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DOI：
10.1002/cncr.25297
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发表时间：
2010-07-15
期刊：
影响因子：
6.2
通讯作者：
Horowitz, Mary M.
中科院分区：
文献类型：
--
作者：
Joshua, Thomas V.;Rizzo, J. Douglas;Zhang, Mei-Jie;Hari, Parameswaran N.;Kurian, Seira;Pasquini, Marcelo;Majhail, Navneet S.;Lee, Stephanie J.;Horowitz, Mary M.
本研究的目的是确定利用造血干细胞移植（HCT）治疗白血病、淋巴瘤或多发性骨髓瘤是否因种族和性别而异。我们使用1997年至2002年的SEER癌症登记处和2000年的美国人口普查报告，按种族和性别估计了美国70岁以下人群中白血病、淋巴瘤和多发性骨髓瘤的年发病率。根据国际血液和骨髓移植研究中心1997年至2002年的数据，估计了美国这些人群中自体、人类白细胞抗原（HLA）相同的兄弟姐妹和不相关的HCT的年发病率。采用Logistic回归计算白种人与非裔美国人、男性与女性接受HCT的年龄校正优势比。白种人接受HCT的可能性高于非裔美国人[比值比(OR) =1.40 (95%CI: 1.34-1.46)]。这种差异存在于不同类型的HCT：自体HCT [OR=1.24 (1.19-1.30)]， HLA同卵同胞HCT [OR=1.59(1.46-1.74)]和非亲属供体HCT [OR=2.02(1.75-2.33)]。总体而言，男性比女性更有可能接受HCT [OR=1.07 (1.05-1.1) p<0.0001]；然而，这种差异仅在自体HCT中有统计学意义[OR=1.10 (1.07-1.13), p<0.0001]。与非裔美国人相比，HCT更常用于治疗白种人的白血病、淋巴瘤和多发性骨髓瘤。非裔美国人的自体和异体HCT发生率都较低，这表明供体的可用性并不能完全解释这种差异。由于年龄或疾病状况等无法解释的原因，女性接受自体HCT的可能性低于男性。
The purpose of this study was to determine whether utilization of Hematopoietic Stem Cell Transplantation (HCT) to treat leukemia, lymphoma or multiple myeloma differs by race and gender. We estimated the annual incidence of leukemia, lymphoma and multiple myeloma in the United States (US) in people younger than 70 years by race and gender using the SEER Cancer Registry between 1997 and 2002 and US Census Reports for year 2000. The annual incidence of autologous, human leukocyte antigen (HLA) identical sibling and unrelated HCT performed in these groups in the US was estimated using Center for International Blood and Marrow Transplant Research data from 1997 to 2002. Logistic regression was used to calculate the age-adjusted odds ratio of receiving HCT for Caucasians versus African-Americans and men versus women. The likelihood of undergoing HCT was higher for Caucasians than for African-Americans [Odds Ratio (OR) =1.40 (95%CI: 1.34-1.46)]. This difference existed for each type of HCT: autologous [OR=1.24 (1.19-1.30)], HLA identical sibling [OR=1.59 (1.46-1.74)] and unrelated donor [OR=2.02 (1.75-2.33)]. Overall, men were more likely than women to receive HCT [OR=1.07 (1.05-1.1) p<0.0001]; however, this difference was significant only for autologous HCT [OR=1.10 (1.07-1.13), p<0.0001]. HCT is more frequently used to treat leukemia, lymphoma and multiple myeloma in Caucasians than in African-Americans. African-Americans have lower rates of both autologous and allogeneic HCT, indicating that donor availability cannot fully explain the differences. Women are less likely than men to receive autologous HCT for reasons unexplained by age or disease status.
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