All content on this site is intended for healthcare professionals only. By acknowledging this message and accessing the information on this website you are confirming that you are a Healthcare Professional.
The GvHD Hub uses cookies on this website. They help us give you the best online experience. By continuing to use our website without changing your cookie settings, you agree to our use of cookies in accordance with our updated Cookie Policy
An expert panel hosted by
Customizing first-line BTK inhibitors for CLL
with Gilles Salles, Paolo Ghia, and Francesc Bosch
Wednesday, October 23, 2024
18:30-19:30 BST
This independent educational activity is supported by Pharmacyclics LLC, an AbbVie Company and Janssen Biotech. All content is developed independently by the faculty. The funder is allowed no influence on the content of this activity.
The GvHD Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the GvHD Hub cannot guarantee the accuracy of translated content. The GvHD Hub and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.
The GvHD Hub is an independent medical education platform, sponsored by Medac and supported through grants from Sanofi and Therakos. The funders are allowed no direct influence on our content. The levels of sponsorship listed are reflective of the amount of funding given. View funders.
Impact of race, ethnicity, and socioeconomic status on outcomes in patients with GvHD
|
A retrospective analysis conducted by the CIMBTR assessed the association between race, ethnicity, and socioeconomic status and the incidence of GvHD and outcomes in patients after a GvHD diagnosis.1 This analysis included 14,825 adult patients with AML, ALL, MDS, or MPN who underwent first allo-HSCT in the US between 2008 and 2018. Results were published in Blood Advances by Farhadfar et al.1 |
| Key learnings: |
| In total, 6,259 and 6,675 patients were diagnosed with aGvHD and cGvHD, respectively. The cumulative incidence of severe aGvHD was higher in non-Hispanic Black patients compared with other racial/ethnic cohorts (p = 0.015). The cumulative incidence of cGvHD at 1, 3, and 5 years after allo-HSCT was not associated with race/ethnicity (p = 0.489) or socioeconomic status (p = 0.441). |
| In the multivariate analysis of patients with aGvHD, race/ethnicity was associated with OS (p = 0.0019) and TRM (p = 0.0002). Non-Hispanic Black patients had a higher overall mortality (HR, 1.31; 95% CI, 1.14–1.50; p = 0.0002) and TRM (HR, 1.5; 95% CI, 1.24–1.83; p = 0.0001) compared with non-Hispanic White patients. This association was lost when aGvHD severity was included as a covariate, suggesting that aGvHD severity partially explains the association of race/ethnicity with OS and TRM. Lower socioeconomic status was associated with an increased risk of relapse (p = 0.0013), but not OS or TRM. |
| Among patients with cGvHD, race/ethnicity was not associated with OS, TRM, or relapse. Socioeconomic status was associated with OS (p < 0.0001) and TRM (p = 0.0002). Patients with an annual household income of ≥$80,000 showed an improved OS (HR, 0.77; 95% CI, 0.69–0.85; p < 0.0001) and lower TRM (HR, 0.86; 95% CI, 0.67–0.87; p < 0.0001) compared with patients with an annual household income of <$48,000. |
| This analysis found that race/ethnicity and socioeconomic status had an impact on outcomes for patients with GvHD. Addressing these disparities in outcomes through better healthcare resource allocation for patients with a lower socioeconomic status and strategies to reduce the risk of severe aGvHD in non-Hispanic Black patients may improve long-term outcomes in clinical practice. |
Abbreviations: aGvHD, acute graft-versus-host disease; ALL, acute lymphoblastic leukemia; allo-HSCT, allogeneic hematopoietic stem cell transplants; AML, acute myeloid leukemia; cGvHD, chronic graft-versus-host disease; CI, confidence interval; CIMBTR, Center for International Blood and Marrow Transplant Research; GvHD, graft-versus-host disease; HR, hazard ratio; MDS, myelodysplastic syndromes; MPN, myeloproliferative neoplasms; OS, overall survival; TRM, transplant-related mortality.
- Farhadfar N, Rashid N, Chen K, et al. Racial, ethnic, and socioeconomic diversity and outcomes of patients with graft-versus-host disease: A CIBMTR analysis. Blood Adv. 2024;8(18):4963-4976. DOI: 1182/bloodadvances.2024013074
More about...
Your opinion matters
4 votes - 57 days left ...
Newsletter
Subscribe to get the best content related to GvHD delivered to your inbox