@article{0d2e267cd18d475f80842b318ae66ed2,
title = "Community health status and outcomes after allogeneic hematopoietic cell transplantation in the United States",
abstract = "Background: The association of community factors and outcomes after hematopoietic cell transplantation (HCT) has not been comprehensively described. Using the County Health Rankings and Roadmaps (CHRR) and the Center for International Blood and Marrow Transplant Research (CIBMTR), this study evaluated the impact of community health status on allogeneic HCT outcomes. Methods: This study included 18,544 adult allogeneic HCT recipients reported to the CIBMTR by 170 US centers in 2014-2016. Sociodemographic, environmental, and community indicators were derived from the CHRR, an aggregate community risk score was created, and scores were assigned to each patient (patient community risk score [PCS]) and transplant center (center community risk score [CCS]). Higher scores indicated less healthy communities. The impact of PCS and CCS on patient outcomes after allogeneic HCT was studied. Results: The median age was 55 years (range, 18-83 years). The median PCS was –0.21 (range, –1.37 to 2.10; standard deviation [SD], 0.42), and the median CCS was –0.13 (range, –1.04 to 0.96; SD, 0.40). In multivariable analyses, a higher PCS was associated with inferior survival (hazard ratio [HR] per 1 SD increase, 1.04; 99% CI, 1.00-1.08; P =.0089). Among hematologic malignancies, a tendency toward inferior survival was observed with a higher PCS (HR, 1.04; 99% CI, 1.00-1.08; P =.0102); a higher PCS was associated with higher nonrelapse mortality (NRM; HR, 1.08; 99% CI, 1.02-1.15; P =.0004). CCS was not significantly associated with survival, relapse, or NRM. Conclusions: Patients residing in counties with a worse community health status have inferior survival as a result of an increased risk of NRM after allogeneic HCT. There was no association between the community health status of the transplant center location and allogeneic HCT outcomes.",
keywords = "allogeneic transplant, community health, hematopoietic cell transplantation, survival",
author = "Sanghee Hong and Ruta Brazauskas and Hebert, {Kyle M.} and Siddhartha Ganguly and Hisham Abdel-Azim and Diaz, {Miguel Angel} and Sara Beattie and Ciurea, {Stefan O.} and David Szwajcer and Badawy, {Sherif M.} and Gratwohl, {Alois A.} and Charles LeMaistre and Aljurf, {Mahmoud D.S.M.} and Olsson, {Richard F.} and Bhatt, {Neel S.} and Nosha Farhadfar and Yared, {Jean A.} and Ayami Yoshimi and Sachiko Seo and Usama Gergis and Beitinjaneh, {Amer M.} and Akshay Sharma and Hillard Lazarus and Jason Law and Matthew Ulrickson and Hasan Hashem and H{\'e}l{\`e}ne Schoemans and Jan Cerny and David Rizzieri and Savani, {Bipin N.} and Kamble, {Rammurti T.} and Shaw, {Bronwen E.} and Nandita Khera and Wood, {William A.} and Shahrukh Hashmi and Theresa Hahn and Lee, {Stephanie J.} and Rizzo, {J. Douglas} and Majhail, {Navneet S.} and Wael Saber",
note = "Funding Information: Navneet S. Majhail is partially supported by a grant from the National Cancer Institute (R01‐CA215134). The Center for International Blood and Marrow Transplant Research is supported primarily by Public Health Service grant/cooperative agreement U24CA076518 from the National Cancer Institute, the National Heart, Lung, and Blood Institute, and the National Institute of Allergy and Infectious Diseases; U24HL138660 from the National Heart, Lung, and Blood Institute and the National Cancer Institute; OT3HL147741, R21HL140314, and U01HL128568 from the National Heart, Lung, and Blood Institute; HHSH250201700006C, SC1MC31881‐01‐00, and HHSH250201700007C from the Health Resources and Services Administration; and N00014‐18‐1‐2850, N00014‐18‐1‐2888, and N00014‐20‐1‐2705 from the Office of Naval Research. Additional federal support is provided by P01CA111412, R01CA152108, R01CA215134, R01CA218285, R01CA231141, R01HL126589, R01AI128775, R01HL129472, R01HL130388, R01HL131731, U01AI069197, U01AI126612, and the Biomedical Advanced Research and Development Authority. Support is also provided by the Be the Match Foundation, Boston Children's Hospital, Dana‐Farber, the Japan Hematopoietic Cell Transplantation Data Center, St. Baldrick's Foundation, the National Marrow Donor Program, the Medical College of Wisconsin, and the following commercial entities: AbbVie; Actinium Pharmaceuticals, Inc; Adaptive Biotechnologies; Adienne SA; AlloVir, Inc; Amgen, Inc; Anthem, Inc; Astellas Pharma US; AstraZeneca; Atara Biotherapeutics, Inc; Bluebird Bio, Inc; Bristol‐Myers Squibb Co; Celgene Corp; Chimerix, Inc; CSL Behring; CytoSen Therapeutics, Inc; Daiichi Sankyo Co, Ltd; Gamida‐Cell, Ltd; Genzyme; GlaxoSmithKline; HistoGenetics, Inc; Incyte Corporation; Janssen Biotech, Inc; Janssen Pharmaceuticals, Inc; Janssen/Johnson & Johnson; Jazz Pharmaceuticals, Inc; Kiadis Pharma; Kite Pharma; Kyowa Kirin; Legend Biotech; Magenta Therapeutics; Mallinckrodt LLC; Medac GmbH; Merck & Company, Inc; Merck Sharp & Dohme Corp; Mesoblast; Millennium (the Takeda Oncology Co); Miltenyi Biotec, Inc; Novartis Oncology; Novartis Pharmaceuticals Corporation; Omeros Corporation; OncoImmune, Inc; Orca Biosystems, Inc; Pfizer, Inc; Pharmacyclics, LLC; Regeneron Pharmaceuticals, Inc; REGiMMUNE Corp; Sanofi Genzyme; Seattle Genetics; Sobi, Inc; Takeda Oncology; Takeda Pharma; Terumo BCT; Viracor Eurofins; and Xenikos BV. The University of Texas MD Anderson Cancer Center is supported by the National Institutes of Health (grant P30 CA016672). The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, the Health Resources and Services Administration, or any other agency of the US government. Funding Information: Siddhartha Ganguly reports personal fees from Seattle Genetics, Kite Pharma, and Kadmon outside the submitted work. Richard F. Olsson reports personal fees from AstraZeneca outside the submitted work. Jean A. Yared reports grants from Gilead and other from Jazz outside the submitted work. Sachiko Seo reports personal fees from Janssen Pharmaceutical KK outside the submitted work. Usama Gergis reports working on speakers' bureaus for Incyte, Merck, Kite, Astellas, and Jazz; consulting for Astellas; and working on ad boards for Mesoblast and Jazz. Akshay Sharma is the principal investigator of a clinical trial for gene therapy of sickle cell disease sponsored by Vertex Pharmaceuticals/CRISPR Therapeutics, and the sponsor provides funding for the clinical trial, which includes salary support paid to Sharma's institution; this is not related in any way to the submitted work. In addition, Sharma reports research collaborations with Novartis, Magenta Therapeutics, and Bluebird Bio, for which he is not financially compensated in any way. H{\'e}l{\`e}ne Schoemans reports nonfinancial support from Celgene, AbbVie, and Incyte; personal fees from Jazz Pharmaceuticals, Novartis, Takeda, Incyte, and Janssen; and grants from Novartis outside the submitted work. Jan Cerny reports other from Jazz Pharmaceuticals, Incyte, and Daiichi‐Sankyo outside the submitted work. David Rizzieri reports personal fees from Amgen, Kite, AROG, Pharmacyclics, Seattle Genetics, Pfizer, Novartis, Sanofi‐Aventis, Incyte, Gilead, Jazz, and Celgene and other from AbbVie, Celltrion/Teva, Mustang, Bayer, and Stemline outside the submitted work. Bronwen E. Shaw reports personal fees from Orca Biosystems and Merck Sharp & Dohme outside the submitted work. William A. Wood reports grants from Pfizer and Genentech outside the submitted work. J. Douglas Rizzo reports other from the Health Resources and Services Administration and Optum Health during the conduct of the study. Navneet S. Majhail reports personal fees from Incyte, Anthem, and Mallinckrodt outside the submitted work. The other authors made no disclosures. ",
year = "2020",
doi = "10.1002/cncr.33232",
language = "English (US)",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
}