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Racial disparities in hematopoietic cell transplantation in the United States

Bone Marrow Transplantation volume 47, pages 1385–1390 (2012)Cite this article

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Abstract

Hematopoietic cell transplantation (HCT) is a highly specialized, expensive and resource-intense medical procedure that can be associated with racial disparities. We review the prevailing literature on racial disparities in HCT in the United States and describe areas for future research and interventions. We discuss the complexity of interpreting race as a biological and social determinant of disease in biomedical research, especially as it relates to HCT. In the United States, race is often a surrogate for socioeconomic, education and health insurance status. We also discuss some of the nuances to consider while reviewing the literature on racial disparities. Disparities by race exist in three areas related to HCT: donor availability, access to HCT and outcomes of HCT. African-Americans/Blacks have a lower likelihood of finding an unrelated donor. Race and ethnicity definitions are country-specific and reconciling race data can represent significant challenges to unrelated donor registries worldwide. African-Americans/Blacks do not have the same access to autologous and allogeneic HCT as Whites. Racial disparities in outcomes of HCT are more prevalent among allogeneic HCT than autologous HCT recipients. More research is required to understand the biological, social, cultural, medical and financial aspects of race that may influence access to HCT and survival after transplantation. Better understanding of racial disparities will minimize inequities, inform health policy, guide development of interventions targeted to eliminate disparities and ensure equitable access to HCT for all populations.

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Acknowledgements

The CIBMTR is partly supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID) and a Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI.

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Authors and Affiliations

  1. National Marrow Donor Program, Minneapolis, MN, USA

    N S Majhail, S Nayyar, M E Burton Santibañez, E A Murphy & E M Denzen

  2. Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA

    N S Majhail

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  1. N S Majhail
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  2. S Nayyar
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  4. E A Murphy
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  5. E M Denzen
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Correspondence to N S Majhail.

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Majhail, N., Nayyar, S., Santibañez, M. et al. Racial disparities in hematopoietic cell transplantation in the United States. Bone Marrow Transplant 47, 1385–1390 (2012). https://doi.org/10.1038/bmt.2011.214

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