Patient socioeconomic status as a prognostic factor for allo-sct

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. Access through your institution Buy or subscribe This is a preview of

subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print issues and online access $259.00 per year only

$21.58 per issue Learn more Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes which are calculated during checkout

ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS IMPACT OF ACCESS TO CARE ON

1-YEAR MORTALITY FOLLOWING ALLOGENEIC BLOOD OR MARROW TRANSPLANTATION Article 08 January 2021 IMPACT OF SOCIOECONOMIC DISPARITIES ON OUTCOMES IN ADULTS UNDERGOING ALLOGENEIC HEMATOPOIETIC

CELL TRANSPLANTATION FOR ACUTE MYELOID LEUKEMIA Article 22 February 2024 THE IMPROVEMENT IN OVERALL SURVIVAL FROM UNRELATED DONOR TRANSPLANTATION IN AUSTRALIA AND NEW ZEALAND IS DRIVEN BY A

REDUCTION IN NON-RELAPSE MORTALITY: A STUDY FROM THE ABMTRR Article 19 April 2022 REFERENCES * Schmitz N, Gratwohl A, Goldman JM . Allogeneic and autologous transplantation for

haematological diseases, solid tumors and immune disorders. Current practice in Europe in 1996 and proposals for an operational classification. Accreditation Sub-Committee of the European

Group for Blood and Marrow Transplantation (EBMT). _Bone Marrow Transplant_ 1996; 17: 471–477. CAS  PubMed  Google Scholar  * Nash R, Pepe M, Storb R, Longton G, Pettinger M, Anasetti C _et

al_. Acute graft-versus-host disease: analysis of risk factors after allogeneic marrow transplantation and prophylaxis with cyclosporine and methotrexate. _Blood_ 1992; 80: 1838–1845. CAS 

PubMed  Google Scholar  * Winston D, Gale R, Meyer D, Young L . Infectious complications of human bone marrow transplantation. _Medicine (Baltimore)_ 1979; 58: 1–31. Article  CAS  Google

Scholar  * Bittencourt H, Rocha V, Chevret S, Socié G, Espérou H, Devergie A _et al_. Association of CD34 cell dose with hematopoietic recovery, infections, and other outcomes after

HLA-identical sibling bone marrow transplantation. _Blood_ 2002; 99: 2726–2733. Article  CAS  PubMed  Google Scholar  * Blakely T, Atkinson J, Kiro C, Blaiklock A, D’Souza A . Child

mortality, socioeconomic position, and one-parent families: independent association and variation by age and cause of death. _Int J Epidemiol_ 2003; 32: 410–418. Article  PubMed  Google

Scholar  * Rutledge T, Reis SE, Olson M, Owens J, Kelsey SF, Pepine CJ _et al_. Socioeconomic status variables predict cardiovascular disease risk factors and prospective mortality risk

among women with chest pain. The WISE study. _Behav Modif_ 2003; 27: 54–67. Article  PubMed  Google Scholar  * Bassanesi S, Azambuja MI, Achutti A . Premature mortality due to cardiovascular

disease and social inequalities in Porto Alegre: from evidence to action. _Arq Bras Cardiol_ 2008; 90: 403–412. Article  Google Scholar  * Cesaroni G, Farchi S, Davoli M, Forastiere F,

Perucci CA . Individual and area-based indicators of socioeconomic status in childhood asthma. _Eur Respir J_ 2003; 22: 619–624. Article  CAS  PubMed  Google Scholar  * Kapral M, Wang H,

Mamdani M . Effect of socioeconomic status on treatment and mortality after stroke. _Stroke_ 2002; 33: 274–275. Article  Google Scholar  * Cross C, Harris J, Recht A . Race, socioeconomic

status and breast carcinoma in the US: what have we learned from clinical studies. _Cancer_ 2002; 95: 1988–1999. Article  PubMed  Google Scholar  * Wrigley H, Roderick P, George S, Smith J,

Mullee M, Goddard J . Inequalities in survival from colorectal cancer: a comparison of the impact of deprivation, treatment, and host factors on observed and cause specific survival. _J

Epidemiol Community Health_ 2003; 57: 301–309. Article  CAS  PubMed  PubMed Central  Google Scholar  * Hole D, McArdle C . Impact of socioeconomic deprivation on outcome after surgery for

colorectal cancer. _Br J Surgery_ 2002; 89: 586–590. Article  CAS  Google Scholar  * Butkus D, Dottes A, Meydrech EF, Barber WH . Effect of poverty and other socio-economic variables on

renal allograft survival. _Transplantation_ 2001; 72: 261–266. Article  CAS  PubMed  Google Scholar  * Savage D, Lindenbaum J, Ryzin J, Struening E, Garret T . Race, poverty, and survival in

multiple myeloma. _Cancer_ 1984; 54: 3085–3094. Article  CAS  PubMed  Google Scholar  * Viana MB, Murao M, Ramos G, Oliveira HM, Carvalho RI, Bastos M _et al_. Malnutrition as a prognostic

factor in lymphoblastic leukaemia: a multivariate analysis. _Arch Dis Child_ 1994; 71: 304–310. Article  CAS  PubMed  PubMed Central  Google Scholar  * Viana MB, Fernandes RAF, Oliveira BMA,

Murao M, Paes CA, Duarte AA . Nutritional and socio-economic status in the prognosis of childhood acute lymphoblastic leukemia. _Haematologica_ 2001; 86: 113–120. CAS  PubMed  Google

Scholar  * Baker KS, Loberiza Jr FR, Yu H, Cairo MS, Bolwell BJ, Bujan-Boza WA _et al_. Outcome of ethnic minorities with acute or chronic leukemia treated with hematopoietic stem-cell

transplantation in the United States. _J Clin Oncol_ 2005; 23: 7032–7042. Article  PubMed  Google Scholar  * Karanth M, Begum G, Cook M, Lawson S, Porter C, Lister N _et al_. Increased acute

GvHD and higher transplant-related mortality in non-Caucasians undergoing standard sibling allogeneic stem cell transplantation. _Bone Marrow Transplant_ 2006; 37: 419–423. Article  CAS 

PubMed  Google Scholar  * Daudt LE, Zechmaister D, Portal L, Neto EC, Silla LM, Giuliani R . Neonatal screening for hemoglobinopathies: a pilot study in Porto Alegre, Rio Grande do Sul,

Brazil. _Cad Saude Publica_ 2002; 18: 833–841. Article  PubMed  Google Scholar  * http://www.ibge.gov.br/home/estatistica/populacao/contagem2007/popmunic2007layoutTCU14112007.xls-visited in

June 2008. * Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J _et al_. Consensus conference on acute GVHD grading. _Bone Marrow Transplant_ 1995; 15: 825–828. CAS  PubMed

  Google Scholar  * Shulman HM, Sullivan KM, Weiden PL, McDonald GB, Striker GE, Sale GE _et al_. Chronic graft-versus-host syndrome in man. A long-term clinicopathologic study of 20 Seattle

patients. _Am J Med_ 1980; 69: 204–217. Article  CAS  PubMed  Google Scholar  * Alexanian R, Balcerzak S, Bonnet JD, Gehan EA, Haut A, Hewlett JS _et al_. Prognostic factors in multiple

myeloma. _Cancer_ 1975; 36: 1192–1201. Article  CAS  PubMed  Google Scholar  * Hu E, Hufford S Lukes R, Berstein-Singer M, Sobel G, Gill P, Pinter-Brown L _et al_. Third-world Hodgkin's

disease at Los Angeles County––University of Southern California Medical Center. _J Clin Oncol_ 1998; 6: 1285–1292. Article  Google Scholar  * Loureiro MM, Morais JC, Milito CB, Portugal

RD, Pulcher W, Spector N . Expression of Epstein–Barr vírus in patients with Hodgkin's disease: report of 64 cases from Rio de Janeiro, Brazil. _J Bras Patol Méd Lab_ 2004; 40: 37–40.

Google Scholar  * Spector N, Costa MA, Pulcheri W, Salgado RC, Nucci M, Andrade CA _et al_. C-MOPP/ABV yields good results in a public hospital population with Hodgkin's disease in

Brazil. _Cancer_ 1993; 71: 2823–2827. Article  CAS  PubMed  Google Scholar  * Eid KAB, Miranda ECM, Vigorito AC, Aranha FJP, Oliveira GB, De Souza CA . The availability of full match sibling

donors and feasibility of allogeneic bone marrow transplantation in Brazil. _Braz J Med Biol Res_ 2003; 36: 315–321. Article  CAS  PubMed  Google Scholar  * Horowitz MM, Rowlings PA . An

update from the International Bone Marrow Transplantation Registry and the autologous blood and marrow transplant registry on current activity in hematopoietic stem cell transplantation.

_Curr Opin Hematol_ 1997; 4: 395–400. Article  CAS  PubMed  Google Scholar  * Loberiza Jr FR, Zhang M-J, Lee SJ, Klein JP, LeMaistre CF, Serna DS _et al_. Association of transplant center

and physician factors on mortality after hematopoietic stem cell transplantation in the United States. _Blood_ 2005; 105: 2979–2987. Article  CAS  PubMed  Google Scholar  * Lisot CL, Silla

LM . Screening for hemoglobinopathies in blood donors from Caxias do Sul, Brazil: prevalence in an Italian colony. _Cad Saude Publica_ 2004; 20: 1595–1601. Article  PubMed  Google Scholar  *

Sommer CK, Goldberck AS, Wagner SC, Castro SM . Neonatal screening for hemoglobinopathies: a one year experience in the public health system in Rio Grande do Sul, Brazil. _Cad Saude

Publica_ 2006; 22: 1709–1714. Article  PubMed  Google Scholar  * http://pt.wikipedia.org/wiki/Rio_Grande_do_Sul-visited in June 2008. Download references AUTHOR INFORMATION AUTHORS AND

AFFILIATIONS * Division of Hematology and Bone Marrow Transplantation, Department of Internal Medicine, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil L Silla, G B Fischer, A

Paz, L E Daudt, I Mitto, B Katz, M da Graça Grossini, H N Bittencourt, A Jochims, L Fogliatto, C M Bittar, J R Friedrisch & R I Bittencourt Authors * L Silla View author publications You

can also search for this author inPubMed Google Scholar * G B Fischer View author publications You can also search for this author inPubMed Google Scholar * A Paz View author publications

You can also search for this author inPubMed Google Scholar * L E Daudt View author publications You can also search for this author inPubMed Google Scholar * I Mitto View author

publications You can also search for this author inPubMed Google Scholar * B Katz View author publications You can also search for this author inPubMed Google Scholar * M da Graça Grossini

View author publications You can also search for this author inPubMed Google Scholar * H N Bittencourt View author publications You can also search for this author inPubMed Google Scholar *

A Jochims View author publications You can also search for this author inPubMed Google Scholar * L Fogliatto View author publications You can also search for this author inPubMed Google

Scholar * C M Bittar View author publications You can also search for this author inPubMed Google Scholar * J R Friedrisch View author publications You can also search for this author

inPubMed Google Scholar * R I Bittencourt View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to L Silla. RIGHTS AND

PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Silla, L., Fischer, G., Paz, A. _et al._ Patient socioeconomic status as a prognostic factor for allo-SCT. _Bone

Marrow Transplant_ 43, 571–577 (2009). https://doi.org/10.1038/bmt.2008.358 Download citation * Received: 10 April 2008 * Revised: 12 September 2008 * Accepted: 16 September 2008 *

Published: 03 November 2008 * Issue Date: April 2009 * DOI: https://doi.org/10.1038/bmt.2008.358 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this

content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative

KEYWORDS * allogeneic BMT * socioeconomic status * transplant-related mortality * overall survival