¹Division of Hematology and Bone Marrow Transplantation, Department of Internal Medicine, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil

Correspondence: Professor L Silla, Division of Hematology and Bone Marrow Transplantation, Department of Internal Medicine, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350 Room 2235, Porto Alegre RS 90035-903, Brazil. E-mail: lsilla@hcpa.ufrgs.br

Received 10 April 2008; Revised 12 September 2008; Accepted 16 September 2008; Published online 3 November 2008.

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.