title: Racial differences in allogeneic hematopoietic cell transplantation outcomes among African Americans and whites.
abstract: The impact of race on outcome has been identified in a number of cancers, with African Americans having poorer survival compared with whites. We conducted a study to investigate the association of race with allogeneic hematopoietic cell transplant (HCT) outcomes. We identified 789 patients (58 African Americans and 731 whites) who underwent allogeneic HCT for hematologic disorders. There were no significant differences between African Americans and white patients in gender, performance status or comorbidity score. However, African Americans were younger than whites (median 40 years versus 47 years, P=0.003) and were more likely to be in remission at HCT (74% versus 57%, P=0.011), to have an HLA-mismatched donor (36% versus 14%, P<0.001), to have positive donor or recipient CMV serostatus (90% versus 69%, P<0.001) and to have received a cord blood transplant (21% versus 6%, P<0.001). In univariate analysis, African Americans had worse overall survival (OS) (HR 1.41, P=0.026) compared with whites, with no significant differences in acute or chronic GvHD, non-CMV infection or relapse. However, after adjusting for several transplant and disease-related factors in multivariate analysis, the OS difference between African Americans and whites became nonsignificant (HR 1.27, P=0.18). These results suggest that race in and of itself does not lead to worse survival post HCT.
authors: Bone Marrow Transplant Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, USA.
authors: B K
authors: BK
authors: Hamilton
authors: Quantitative Health Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA.
authors: L
authors: L
authors: Rybicki
authors: Leukemia Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, USA.
authors: M
authors: M
authors: Sekeres
authors: Bone Marrow Transplant Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, USA.
authors: M
authors: M
authors: Kalaycio
authors: Pediatric Hematology Oncology, Cleveland Clinic, Cleveland, OH, USA.
authors: R
authors: R
authors: Hanna
authors: Bone Marrow Transplant Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, USA.
authors: R
authors: R
authors: Sobecks
authors: Bone Marrow Transplant Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, USA.
authors: R
authors: R
authors: Dean
authors: Bone Marrow Transplant Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, USA.
authors: H
authors: H
authors: Duong
authors: Bone Marrow Transplant Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, USA.
authors: B T
authors: BT
authors: Hill
authors: Bone Marrow Transplant Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, USA.
authors: B
authors: B
authors: Bolwell
authors: Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, USA.
authors: E
authors: E
authors: Copelan
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D064591:Allografts; D003586:Cytomegalovirus Infections / Q000208:ethnology / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000208:ethnology / Q000401:mortality; D019337:Hematologic Neoplasms / Q000208:ethnology / Q000401:mortality / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D044465:White People