Exploring Subgroups of Patients Likely to Refuse HSCT for Myeloma Treatment

Chakra Chaulagain, MD, director of the multiple myeloma and amyloidosis program at Cleveland Clinic Florida, discusses findings from a comprehensive examination of National Cancer Database data from 2004 to 2020 regarding the utilization of autologous hematopoietic stem cell transplantation (HSCT) in patients with multiple myeloma.

The study found that a small yet significant percentage of patients with multiple myeloma are refusing this potentially life-saving procedure. Here, Chaulagain also discusses the subgroups of patients who were more likely to refuse HSCT.

Transcription:

0:09 | We had 43,600 patients [with] newly diagnosed multiple myeloma, and they were recommended to undergo a stem cell transplantation after completing their initial induction therapy by their doctors. Ninety-eight percent of the patients did go and do the stem cell transplantation, but 2% refused. We analyzed the various socioeconomic, racial, ethnic, and geographic factors about what made them refuse the stem cell transplantation.

0:50 | We did find that older patients had a higher odds of refusing essential transplantation. Male [patients] had higher odds of accepting transplantation and females had higher odds of refusing it. Patients with more major medical comorbidities had higher odds of refusing it. Patients without insurance, or Medicare and Medicaid, had higher odds of refusing stem cell transplantation compared with patients who had private insurance. Median household income was also a significant predictor of whether the patient will go for a stem cell transplant or not. Those who were earning less than $63,000 annually had a higher odds of refusing autologous stem cell transplantation. Black patients, for example, had a higher odds of refusing transplantation, and Hispanic [patients] had a lower odds of refusing transplantation.

REFERENCE:

1. Chaulagain CP, Saba L, Sarna K, et al. Exploring autologous hematopoietic Stem cell transplantation (HSCT) utilization and HSCT refusal trends in multiple myeloma patients: A comprehensive examination of NCDB data from 2004 to 2020. Blood. 2023;142 (Suppl 1): 532. doi:10.1182/blood-2023-182051