title: Patient socioeconomic status as a prognostic factor for allo-SCT.
abstract: The aim of the present study was to assess the influence of socioeconomic status (SeS) on the outcome of allo-SCT at a Brazilian SCT center. In total, 201 patients receiving HLA-identical related allo-SCTs were studied. The median age was 30 years. Overall, 163 patients had malignancies (CML 68, ALL/AML 63, myelodysplastic syndrome 12 and others 20). SeS was defined according to the Brazilian Association of Market Research Agencies classification, where people are clustered in groups A-E (richest to poorest). In total, 146 patients (72%) were classified as richest (A+B+C) and 55 (28%) as poorest (D+E). The D+E SeS group was associated with a higher incidence of chronic GVHD and acute GVHD (hazard ratio (HR)=2.61; P=0.001 and HR=2.62; P=0.001, respectively), better platelet and neutrophil engraftment (HR=1.94; P=<0.001 and HR=2.12; P=0.001) and with a higher TRM in multivariate analysis (HR=1.92; P=0.039). Estimated overall survival at 5 years was 55.2%. A D+E SeS (HR=2.13; P=0.001) was associated with a worse survival on multivariate analysis. In conclusion, a lower SeS is a strong prognostic factor in patients undergoing allo-SCT in Brazil, influencing engraftment, TRM and overall survival.
authors.affiliation: Department of Internal Medicine, Division of Hematology and Bone Marrow Transplantation, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil. lsilla@hcpa.ufrgs.br
authors.forename: L
authors.initials: L
authors.lastname: Silla
authors.forename: G B
authors.initials: GB
authors.lastname: Fischer
authors.forename: A
authors.initials: A
authors.lastname: Paz
authors.forename: L E
authors.initials: LE
authors.lastname: Daudt
authors.forename: I
authors.initials: I
authors.lastname: Mitto
authors.forename: B
authors.initials: B
authors.lastname: Katz
authors.forename: M
authors.initials: M
authors.lastname: da Graça Grossini
authors.forename: H N
authors.initials: HN
authors.lastname: Bittencourt
authors.forename: A
authors.initials: A
authors.lastname: Jochims
authors.forename: L
authors.initials: L
authors.lastname: Fogliatto
authors.forename: C M
authors.initials: CM
authors.lastname: Bittar
authors.forename: J R
authors.initials: JR
authors.lastname: Friedrisch
authors.forename: R I
authors.initials: RI
authors.lastname: Bittencourt
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012923:Social Class