U.S. Study Shows Social and Economic Factors Limit Access to AML Transplants

While the relationship between social determinants of health and patient outcomes is well-established in many areas of medicine, their specific impact on blood cancer treatment has remained largely unexplored. A groundbreaking study presented at the 2024 American Society of Hematology (ASH) Annual Meeting now reveals how these factors affect access to potentially curative stem cell transplants for acute myeloid leukemia (AML) patients.

"To the best of our knowledge, this is the first prospective, multi-center study to evaluate the impact of specific social determinants of health on access to stem cell transplant and survival outcomes," says Dr. Natalie Wuliji from Fred Hutchinson Cancer Center. 

This study looks at an important issue in blood cancer care: how do social and economic factors affect patients' access to allogeneic transplants and their survival during and after the procedure?

Understanding Social Determinants of Health

Social determinants of health (SDOH) are the conditions in which people live, learn, work, and age that affect their health outcomes. Previous research has shown that these factors significantly impact both survival outcomes and access to treatment across various diseases. However, this study is the first to specifically examine their role in transplant access and outcomes for AML patients.

Key Findings from the Study

The research team followed 692 adult AML patients across 13 U.S. medical centers for an average of 4.5 years after diagnosis. By analyzing patients' zip codes alongside U.S. Census Bureau data, they found that patients from areas with lower education levels and higher poverty rates faced significant barriers to receiving transplants:

• The likelihood of receiving a transplant decreased by 30% in areas where more residents had less than a high school education

• Patients from areas with higher rates of federal assistance program use (SNAP benefits or Supplemental Security Income) were less likely to receive transplants

• The risk of dying without receiving a transplant increased by 24% in areas with lower education levels

"We found that social and economic barriers have a greater impact on the ability to receive a transplant or on the risk of death before transplant than on outcomes after the transplant," explains Dr. Wuliji.

In an exclusive interview with HealthTree, Dr. Mohamed Sorror from Fred Hutchinson Cancer Center discusses these important findings and their implications for patients:

Hope Through Action

Importantly, the study found that once patients accessed transplant, social and economic barriers had less impact on survival outcomes. This suggests that improving access to transplants could help reduce healthcare disparities in AML treatment.

Several initiatives are already underway to address these disparities:

• Development of targeted interventions for patients facing socioeconomic barriers

• Creation of transplant-focused patient education materials

• Ongoing trials to increase participation from underrepresented groups

• Efforts to address financial barriers and improve health literacy

Looking Forward

The research team emphasizes the need to address these barriers systematically to ensure that all eligible patients can benefit from potentially life-saving transplants. 

Future studies will explore additional ways to improve access to transplants for patients from areas with lower education levels or higher poverty rates, with a focus on gathering more detailed patient-level data to better understand individual circumstances.

Stay informed about the latest developments in AML research and treatment by following our comprehensive coverage of ASH 2024 at HealthTree's AML Conference Coverage and subscribing to our Newsletter:

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Source:

• Impact of Socioeconomic Factors on Access to and Outcomes of Allogeneic Hematopoietic Cell Transplantation (allo-HCT) for Acute Myeloid Leukemia (AML): A Multi-Center Observational Study