Disparities in Access to Hematopoietic Cell Transplant Persist at a Transplant Center

Abstract

Abstract Race, ethnicity, and socioeconomic status impact access to hematopoietic cell transplant (HCT). Whether differences in accessibility occur within HCT centers remains unknown. We performed a single-center retrospective review of 1,102 patients who underwent HCT consultation. We examined the association between race (Black vs. non-Black and White vs. non-White), ethnicity (Hispanic vs. non-Hispanic) and socioeconomic status (defined by zip code median household income quartiles) with receipt of HCT, time to HCT, and Psychosocial Assessment of Candidates for Transplantation (PACT) scores. Race and ethnicity were not associated with receipt of HCT (p>0.20 for all comparisons). Those living in higher income quartiles and those with private insurance were more likely to receive HCT (p=0.02 and p<0.001, respectively). Among HCT recipients, patients of White race had a shorter time to transplant than those of non-White race (p=0.0175). There was a strong association between lower PACT scores and poorer income quartiles (p<0.001). Socioeconomic status impacts receipt of HCT and PACT scores among patients evaluated at an HCT center. Race and ethnicity did not affect receipt of HCT. However, non-White patients waited longer from consultation to transplant. Further investigation as to whether the psychosocial eligibility evaluation impedes access to HCT in vulnerable populations is warranted.