Outcomes of hematologic malignancies after unrelated donor hematopoietic cell transplantation according to place of residence. Biol Blood Marrow Transplant 2010 Mar;16(3):368-75
Date
11/03/2009Pubmed ID
19879951Pubmed Central ID
PMC2822013DOI
10.1016/j.bbmt.2009.10.028Scopus ID
2-s2.0-75749146165 (requires institutional sign-in at Scopus site) 26 CitationsAbstract
Studies suggest that patients who live in rural areas may have worse clinical outcomes compared with patients living in urban areas. We studied whether place of residence (rural versus urban) is associated with clinical outcomes of patients with leukemia or myelodysplastic syndrome (MDS) who received an unrelated donor hematopoietic cell transplantation (HCT). Patients' residential ZIP code at the time of transplant was used to determine rural or urban designation based on the Rural Urban Commuting Codes. The study included 6140 patients reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) from 121 U.S. HCT centers: 1179 (19%) came from rural areas, whereas 4961 (81%) came from urban areas. Rural and urban patients were similar in patient-, disease-, and transplant-related characteristics aside from household income and distance traveled to the HCT center. After adjusting for income and other significant patient, disease, and transplant-related variables, the risk of overall mortality between patients residing in rural and urban areas were not statistically significant (relative risk 1.01, 95% confidence intervals 0.93-1.10, P = .74). Similar outcomes were noted for treatment-related mortality (TRM), disease-free survival (DFS), and relapse. Patient's income, derived from the U.S. Census and based on their residential ZIP code, was independently associated with outcomes. In summary, our study showed no differences in the clinical outcomes of patients from rural or urban areas after unrelated donor HCT.
Author List
Loberiza FR Jr, Lee SJ, Klein JP, Hassebroek A, Dehn JG, Frangoul HA, Hahn T, Hale G, Lazarus HM, LeMaistre CF, Maziarz RT, Rizzo JD, Majhail NSAuthor
J. Douglas Rizzo MD, MS Director, Center Associate Director, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Child
Child, Preschool
Disease-Free Survival
Female
Graft Rejection
Graft vs Host Disease
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Humans
Income
Infant
Kaplan-Meier Estimate
Male
Middle Aged
Postoperative Complications
Recurrence
Retrospective Studies
Risk Factors
Rural Health
Transplantation, Homologous
Treatment Outcome
United States
Urban Health
Young Adult
