What population-based databases reveal about equity in access to hematopoietic cell transplant and cellular therapy

IF 7.2 2区医学 Q1 HEMATOLOGY

Blood Reviews Pub Date : 2026-07-01 DOI:10.1016/j.blre.2026.101417

Sanghee Hong, Manuel Ricardo Espinoza-Gutarra, Rahul Shah, Patrick Demartino, Stella M. Davies, Eneida Nemecek, Dianna Howard, Anna M. DeSalvo, Christa L. Meyer, Navneet S. Majhail, Jaime Preussler, Anurekha G. Hall, Alexandra Gomez Arteaga, Jeffery J. Auletta, Nandita Khera, On behalf of the American Society of Transplantation, Cellular Therapy (ASTCT)- National Marrow Donor Program (NMDP) ACCESS Initiative

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引用次数: 0

Abstract

Background

Large population-based databases are increasingly used to study access to hematopoietic cell transplantation (HCT) and chimeric antigen receptor T-cell (CAR-T) therapy.

Methods

We conducted a systematic scoping review of studies using US databases (1/2008–2/2025) to examine access to HCT or CAR-T therapy for hematologic malignancies to identify limitations and explain differences in reported disparities.

Results

Thirty-five studies met inclusion criteria, and 46% used linked databases. Across data sources, older age, racial and ethnic minoritized status, lower neighborhood socioeconomic status, and non-private insurance were associated with lower likelihood of HCT and CAR-T receipt. However, disparities varied substantially by databases due to differences in eligible populations, data availability, and ability to identify treatment candidacy.

Conclusion

No single database adequately characterizes disparities in access to cellular therapies. Equity-focused research requires deliberate alignment of research questions with database strengths and greater investment in data standardization and inclusion of social determinants of health.

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基于人群的数据库揭示了获得造血细胞移植和细胞治疗的公平性。

背景：基于人群的大型数据库越来越多地用于研究造血细胞移植（HCT）和嵌合抗原受体t细胞（CAR-T）治疗的可及性。方法：我们对使用美国数据库（1/2008-2/2025）的研究进行了系统的范围审查，以检查HCT或CAR-T治疗血液恶性肿瘤的可及性，以确定局限性并解释报告差异的差异。结果：35项研究符合纳入标准，46%的研究使用了链接数据库。在所有数据来源中，年龄较大、种族和少数民族地位、较低的社区社会经济地位和非私人保险与接受HCT和CAR-T的可能性较低相关。然而，由于符合条件的人群、数据可用性和确定治疗候选性的能力的差异，不同数据库的差异很大。结论：没有单一的数据库能够充分表征细胞治疗的可及性差异。以公平为重点的研究需要将研究问题与数据库优势结合起来，并在数据标准化和纳入健康的社会决定因素方面加大投资。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Blood Reviews 医学-血液学

CiteScore

13.80

自引率

1.40%

发文量

期刊介绍： Blood Reviews, a highly regarded international journal, serves as a vital information hub, offering comprehensive evaluations of clinical practices and research insights from esteemed experts. Specially commissioned, peer-reviewed articles authored by leading researchers and practitioners ensure extensive global coverage across all sub-specialties of hematology.