Differences in characteristics of United States hematopoietic stem cell transplant (HSCT) centers by proportion of ethnic minorities

Abstract

6028 Background: The International Bone Marrow Transplant Registry has reported higher mortality in Hispanics with leukemia and received HLA-identical sibling transplantation when compared to whites. It is unknown if transplant center characteristics can partially explain this disparity. We hypothesize that transplant centers do not systematically differ according to the proportion of minorities transplanted. We compared the characteristics of transplant centers that perform a higher proportion of minorities to centers performing transplants to a predominantly white population. Methods: We obtained center characteristics on 116 U.S. transplant centers performing HLA-identical sibling transplantation and compared the following: physician and other health care provider; transplant unit procedure and resources; and, medical center organization according to the volume percentage of minorities transplanted (high ≥ 20% vs. low< 20 %) and percentage of Hispanics transplanted (high ≥10% vs. low <10 %). Results: Centers transplanting a higher proportion of minorities were more likely to perform fewer transplants/year (40 v 66, p<.01), have fewer devoted transplant beds (10 v 13, p<.05), more likely to be in an urban setting (93% v 73%, p<.01), have lower physician to patient ratio (1:13 v 1:16, p<.03), and were more likely to follow survivors after a year after transplantation (83% v 66%, p<.03). Centers transplanting a higher proportion of Hispanics were also more likely to perform fewer transplants/year (36 v 62, p<.02), have fewer devoted transplant beds (7 v 12, p<.001), less likely to be transplanted in centers performing outpatient transplants (25% vs 56%, p<.005), more likely to be in urban setting (96% v 77%, p<.02), and less likely to have a post-transplant immunization protocol (61% v 83%, p<.01). Conclusions: Center characteristics appear to differ according to the proportion of minorities transplanted; further studies should address the association of these characteristics and it's impact on mortality No significant financial relationships to disclose.