title: Racial disparities in hematopoietic cell transplantation in the United States.
abstract: Hematopoietic cell transplantation (HCT) is a highly specialized, expensive and resource-intense medical procedure that can be associated with racial disparities. We review the prevailing literature on racial disparities in HCT in the United States and describe areas for future research and interventions. We discuss the complexity of interpreting race as a biological and social determinant of disease in biomedical research, especially as it relates to HCT. In the United States, race is often a surrogate for socioeconomic, education and health insurance status. We also discuss some of the nuances to consider while reviewing the literature on racial disparities. Disparities by race exist in three areas related to HCT: donor availability, access to HCT and outcomes of HCT. African-Americans/Blacks have a lower likelihood of finding an unrelated donor. Race and ethnicity definitions are country-specific and reconciling race data can represent significant challenges to unrelated donor registries worldwide. African-Americans/Blacks do not have the same access to autologous and allogeneic HCT as Whites. Racial disparities in outcomes of HCT are more prevalent among allogeneic HCT than autologous HCT recipients. More research is required to understand the biological, social, cultural, medical and financial aspects of race that may influence access to HCT and survival after transplantation. Better understanding of racial disparities will minimize inequities, inform health policy, guide development of interventions targeted to eliminate disparities and ensure equitable access to HCT for all populations.
authors: National Marrow Donor Program, Minneapolis, MN 55413, USA. nmajhail@nmdp.org
authors: N S
authors: NS
authors: Majhail
authors: S
authors: S
authors: Nayyar
authors: M E Burton
authors: ME
authors: Santibañez
authors: E A
authors: EA
authors: Murphy
authors: E M
authors: EM
authors: Denzen
mesh_terms: D044383:Black People / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000208:ethnology* / Q000706:statistics & numerical data*; D018380:Hematopoietic Stem Cell Transplantation / Q000208:ethnology* / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American