Country-Level Macroeconomic Indicators Predict Early Post-Allogeneic Hematopoietic Cell Transplantation Survival in Acute Lymphoblastic Leukemia: A CIBMTR Analysis

William A Wood; Ruta Brazauskas; Zhen-Huan Hu; Hisham Abdel-Azim; Ibrahim A Ahmed; Mahmoud Aljurf; Sherif Badawy; Amer Beitinjaneh; Biju George; David Buchbinder; Jan Cerny; Laurence Dedeken; Miguel Angel Diaz; Cesar O Freytes; Siddhartha Ganguly; Usama Gergis; David Gomez Almaguer; Ashish Gupta; Gregory Hale; Shahrukh K Hashmi; Yoshihiro Inamoto; Rammurti T Kamble; Kehinde Adekola; Tamila Kindwall-Keller; Jennifer Knight; Lalit Kumar; Yachiyo Kuwatsuka; Jason Law; Hillard M Lazarus; Charles LeMaistre; Richard F Olsson; Michael A Pulsipher; Bipin N Savani; Kirk R Schultz; Ayman A Saad; Matthew Seftel; Sachiko Seo; Thomas C Shea; Amir Steinberg; Keith Sullivan; David Szwajcer; Baldeep Wirk; Jean Yared; Agnes Yong; Jignesh Dalal; Theresa Hahn; Nandita Khera; Carmem Bonfim; Yoshiko Atsuta; Wael Saber

doi:10.1016/j.bbmt.2018.03.016

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Country-Level Macroeconomic Indicators Predict Early Post-Allogeneic Hematopoietic Cell Transplantation Survival in Acute Lymphoblastic Leukemia: A CIBMTR Analysis

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Country-Level Macroeconomic Indicators Predict Early Post-Allogeneic Hematopoietic Cell Transplantation Survival in Acute Lymphoblastic Leukemia: A CIBMTR Analysis

William A Wood, Ruta Brazauskas, Zhen-Huan Hu, Hisham Abdel-Azim, Ibrahim A Ahmed, Mahmoud Aljurf, Sherif Badawy, Amer Beitinjaneh, Biju George, David Buchbinder, …

Biology of blood and marrow transplantation, Vol.24(9), pp.1928-1935

2018-09

DOI: https://doi.org/10.1016/j.bbmt.2018.03.016

PMID: 29567340

Abstract

Bone marrow

Health expenditures

Outcome assessment (Health care)

Precursor cell lymphoblastic leukemia-lymphoma

Hematopoietic stem cell transplantation

•alloHCT is performed in a variety of countries with higher and lower overall macroeconomic indices.•Transplants performed in countries with lower macroeconomic indices were associated with worse 100-day overall survival.•Additional research is needed to see if macroeconomic indicators are associated with longer-term disease-free survival and overall survival following alloHCT for ALL. For patients with acute lymphoblastic leukemia (ALL), allogeneic hematopoietic cell transplantation (alloHCT) offers a potential cure. Life-threatening complications can arise from alloHCT that require the application of sophisticated health care delivery. The impact of country-level economic conditions on post-transplantation outcomes is not known. Our objective was to assess whether these variables were associated with outcomes for patients transplanted for ALL. Using data from the Center for Blood and Marrow Transplant Research, we included 11,261 patients who received a first alloHCT for ALL from 303 centers across 38 countries between the years of 2005 and 2013. Cox regression models were constructed using the following macroeconomic indicators as main effects: Gross national income per capita, health expenditure per capita, and Human Development Index (HDI). The outcome was overall survival at 100 days following transplantation. In each model, transplants performed within lower resourced environments were associated with inferior overall survival. In the model with the HDI as the main effect, transplants performed in the lowest HDI quartile (n = 697) were associated with increased hazard for mortality (hazard ratio, 2.42; 95% confidence interval, 1.64 to 3.57; P < .001) in comparison with transplants performed in the countries with the highest HDI quartile. This translated into an 11% survival difference at 100 days (77% for lowest HDI quartile versus 88% for all other quartiles). Country-level macroeconomic indices were associated with lower survival at 100 days after alloHCT for ALL. The reasons for this disparity require further investigation.

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.103 Blood Disorders; 1.103.380 GvHD
Web Of Science research areas: Hematology; Immunology; Transplantation
ESI research areas: Immunology

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Title: Country-Level Macroeconomic Indicators Predict Early Post-Allogeneic Hematopoietic Cell Transplantation Survival in Acute Lymphoblastic Leukemia: A CIBMTR Analysis
Creators: William A Wood - Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
Ruta Brazauskas - Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Zhen-Huan Hu - Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Hisham Abdel-Azim - Division of Hematology, Oncology, and Blood & Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California
Ibrahim A Ahmed - Department of Hematology, Oncology, and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, Missouri
Mahmoud Aljurf - Department of Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
Sherif Badawy - Division of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
Amer Beitinjaneh - Department of Hematology/Oncology, University of Miami, Miami, Florida
Biju George - Christian Medical College, Vellore, India
David Buchbinder - Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, California
Jan Cerny - Division of Hematology/Oncology, UMass Memorial Medical Center, Worcester, Massachusetts
Laurence Dedeken - Department of Hematology Oncology, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium
Miguel Angel Diaz - Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
Cesar O Freytes - Texas Transplant Institute, San Antonio, Texas
Siddhartha Ganguly - Blood and Marrow Transplantation, Division of Hematology and Oncology, University of Kansas Medical Center, Kansas City, Kansas
Usama Gergis - Hematolgic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
David Gomez Almaguer - Hospital Universidad Autónoma de Nuevo León, Monterrey, Mexico
Ashish Gupta - Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio
Gregory Hale - Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
Shahrukh K Hashmi - Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
Yoshihiro Inamoto - Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
Rammurti T Kamble - Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
Kehinde Adekola - Division of Hematology/Oncology, Department of Medicine and Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Tamila Kindwall-Keller - Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, Virginia
Jennifer Knight - Department of Psychology, Medical College of Wisconsin, Milwaukee, Wisconsin
Lalit Kumar - Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
Yachiyo Kuwatsuka - Center for Advanced Medicine and Clinical Research, Nagoya University Graduate School of Medicine, Nagoya, Japan
Jason Law - Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, Boston, Massachusetts
Hillard M Lazarus - Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio
Charles LeMaistre - Hematology and Bone Marrow Transplant, Sarah Cannon, Nashville, Tennessee
Richard F Olsson - Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
Michael A Pulsipher - Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California
Bipin N Savani - Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
Kirk R Schultz - Department of Pediatric Hematology, Oncology and Bone Marrow Transplant, British Columbia's Children's Hospital, The University of British Columbia, Vancouver, British Columbia, Canada
Ayman A Saad - Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
Matthew Seftel - Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, Canada
Sachiko Seo - Department of Hematology and Oncology, National Cancer Research Center East, Chiba, Japan
Thomas C Shea - Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
Amir Steinberg - Department of Hematology-Oncology, Mount Sinai Hospital, New York, New York
Keith Sullivan - Duke University Medical Center, Durham, North Carolina
David Szwajcer - Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, Canada
Baldeep Wirk - Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington
Jean Yared - Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland
Agnes Yong - Royal Adelaide Hospital/SA Pathology and School of Medicine, University of Adelaide, Adelaide, Australia
Jignesh Dalal - Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio
Theresa Hahn - Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York
Nandita Khera - Department of Hematology/Oncology, Mayo Clinic, Phoenix, Arizona
Carmem Bonfim - Hospital de Clinicas—Federal University of Parana, Curitiba, Brazil
Yoshiko Atsuta - Center for Advanced Medicine and Clinical Research, Nagoya University Graduate School of Medicine, Nagoya, Japan
Wael Saber - Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Publication Details: Biology of blood and marrow transplantation, Vol.24(9), pp.1928-1935
Publisher: Elsevier Inc
Grant note: NHLBI (https://doi.org/10.13039/100000050) NIAID (https://doi.org/10.13039/100000060) NCI (https://doi.org/10.13039/100010582)
Academic Unit: Miller School of Medicine; UMMG Dept of Medicine - Hematology/Oncology
Language: English
Resource Type: Journal article
PMID: 29567340
Record Identifier: 991031599436402976