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Outcomes after hematopoietic cell transplantation among non-English- compared to English-speaking recipients

Bone Marrow Transplantation volume 57, pages 440–444 (2022)Cite this article

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Abstract

Multiple studies have documented that racial/ethnic minority patients are less likely to undergo hematopoietic cell transplantation (HCT) in the United States (US), and if they do, they often have worse outcomes. No studies to our knowledge have compared the outcomes of English-speakers to non-English speakers undergoing HCT in the US. To test our hypothesis that non-English speakers have worse outcomes than English speakers after HCT, all transplants performed between 2015 and 2019 at Fred Hutchinson Cancer Research Center in Seattle, WA, USA were analyzed. Cox proportional hazards models were used to test our hypothesis, adjusting for significant clinical covariates. Out of 2051 patients, 106 (5%) were documented to be non-English speakers. Mortality for non-English speakers was not different than English speakers (adjusted HR 1.02, 95% CI 0.63–1.63, p = 0.95). When the analysis was limited to the allogeneic population, the results were similar to the total population (adjusted HR 1.10, 0.64–1.88, p = 0.73). The risk of grade II-IV acute graft-versus-host disease (GVHD) was higher in the non-English speaking subset: adjusted OR 2.01, 95% CI, 1.02–3.98, p = 0.04. These data suggest that non-English speakers have similar survival compared to English speakers following HCT although they have more acute GVHD.

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Fig. 1
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Fig. 3: Forest plot of outcomes.

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Acknowledgements

This work was supported by grants CA018029 and CA15704.

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Authors and Affiliations

  1. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Ahona Mukherjee, Ted Gooley, Marco Mielcarek, Brenda M. Sandmaier, Kris Doney, Masumi Ueda Oshima, Leona Holmberg, K. Scott Baker, Rachel B. Salit, Elizabeth F. Krakow, Kathleen Shannon-Dorcy, Chris Davis & Stephanie J. Lee

  2. Department of Medicine, University of Washington, Seattle, WA, USA

    Marco Mielcarek, Brenda M. Sandmaier, Kris Doney, Masumi Ueda Oshima, Leona Holmberg, Rachel B. Salit, Elizabeth F. Krakow & Stephanie J. Lee

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  1. Ahona Mukherjee
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Contributions

Designed study (SJL), performed analysis (TG, CD), interpreted data (all authors), wrote the paper (AM, SJL, TG), critically revised the paper (all authors).

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Correspondence to Stephanie J. Lee.

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Mukherjee, A., Gooley, T., Mielcarek, M. et al. Outcomes after hematopoietic cell transplantation among non-English- compared to English-speaking recipients. Bone Marrow Transplant 57, 440–444 (2022). https://doi.org/10.1038/s41409-021-01557-7

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