Patient socioeconomic status as a prognostic factor for allo-SCT

Bone Marrow Transplant. 2009 Apr;43(7):571-7. doi: 10.1038/bmt.2008.358. Epub 2008 Nov 3.

Abstract

The aim of the present study was to assess the influence of socioeconomic status (SeS) on the outcome of allo-SCT at a Brazilian SCT center. In total, 201 patients receiving HLA-identical related allo-SCTs were studied. The median age was 30 years. Overall, 163 patients had malignancies (CML 68, ALL/AML 63, myelodysplastic syndrome 12 and others 20). SeS was defined according to the Brazilian Association of Market Research Agencies classification, where people are clustered in groups A-E (richest to poorest). In total, 146 patients (72%) were classified as richest (A+B+C) and 55 (28%) as poorest (D+E). The D+E SeS group was associated with a higher incidence of chronic GVHD and acute GVHD (hazard ratio (HR)=2.61; P=0.001 and HR=2.62; P=0.001, respectively), better platelet and neutrophil engraftment (HR=1.94; P=<0.001 and HR=2.12; P=0.001) and with a higher TRM in multivariate analysis (HR=1.92; P=0.039). Estimated overall survival at 5 years was 55.2%. A D+E SeS (HR=2.13; P=0.001) was associated with a worse survival on multivariate analysis. In conclusion, a lower SeS is a strong prognostic factor in patients undergoing allo-SCT in Brazil, influencing engraftment, TRM and overall survival.

MeSH terms

  • Adolescent
  • Adult
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Female
  • Graft vs Host Disease / epidemiology
  • Graft vs Host Disease / etiology
  • Hematopoietic Stem Cell Transplantation* / mortality
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Prognosis
  • Recurrence
  • Social Class*