{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:57:08Z","timestamp":1790139428683,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"20","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007273","name":"Weill Cornell Medical College","doi-asserted-by":"publisher","award":["Dean\u2019s Diversity Award"],"award-info":[{"award-number":["Dean\u2019s Diversity Award"]}],"id":[{"id":"10.13039\/100007273","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Racial\/ethnic disparities in the utilization of hematopoietic cell transplantation (HCT) have been reported for patients with hematologic malignancies, but population\u2010based data are lacking for lymphoma patients. The objective of this study was to determine whether racial and ethnic disparities exist in the utilization of autologous HCT for lymphoma in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We used Surveillance, Epidemiology, and End Results data linked to Medicare fee\u2010for\u2010service claims. We included Medicare beneficiaries aged 66+ years with Hodgkin or Non\u2010Hodgkin lymphomas diagnosed between 2008 and 2015. The primary outcome was time\u2010to\u2010autologous HCT. We used Cox proportional hazards models to estimate racial\/ethnic differences in utilization. Missing data were handled using multiple imputation with chained equations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 40,605 individuals with lymphoma. A total of 452 autologous transplants were performed. In the unadjusted model, Non\u2010Hispanic Black patients were 51% less likely to receive a transplant than Non\u2010Hispanic White patients (95% CI, 0.26\u20130.96;<jats:italic>p\u00a0<\/jats:italic>=\u00a00.04). After adjusting for age at diagnosis and sex, Non\u2010Hispanic Black patients were 61% less likely to receive a transplant (95% CI, 0.20\u20130.76;<jats:italic>p\u00a0<\/jats:italic>=\u00a00.01). However, observed differences attenuated and became non\u2010significant after adjustment for socioeconomic factors (adjusted hazard ratio [aHR], 0.62; 95% CI, 0.32\u20131.21;<jats:italic>p<\/jats:italic>\u00a0=\u00a00.16) and disease\u2010specific factors (aHR, 0.58; 95% CI, 0.30\u20131.12;<jats:italic>p\u00a0<\/jats:italic>=\u00a00.11), separately. In the fully adjusted model, we also did not observe a statistically significant association between Non\u2010Hispanic Black race\/ethnicity and receipt of transplant (aHR, 0.54; 95% CI, 0.28\u20131.05;<jats:italic>p\u00a0<\/jats:italic>=\u00a00.07).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this population\u2010based cohort study of lymphoma patients, Non\u2010Hispanic Black patients were less likely to receive autologous HCT compared to Non\u2010Hispanic White patients, but this difference was partially explained by socioeconomic and disease\u2010specific factors.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.4249","type":"journal-article","created":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T14:38:50Z","timestamp":1630507130000},"page":"7330-7338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Racial and ethnic differences in the utilization of autologous transplantation for lymphoma in the United States"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8122-3852","authenticated-orcid":false,"given":"John L.","family":"Vaughn","sequence":"first","affiliation":[{"name":"Division of Hematology &amp; Medical Oncology Weill Cornell Medicine New York New York USA"},{"name":"Clinical Epidemiology &amp; Health Services Research Program Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orysya","family":"Soroka","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8216-3457","authenticated-orcid":false,"given":"Narendranath","family":"Epperla","sequence":"additional","affiliation":[{"name":"Division of Hematology The Ohio State University Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Safford","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6920-8526","authenticated-orcid":false,"given":"Laura C.","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21654"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2020.03.002"},{"key":"e_1_2_9_4_1","unstructured":"Center for International Blood and Marrow Transplant ResearchNumber of HCTs performed in the United States and reported to CIBMTR \u2010 donor type and disease category by year 2013\u20132017. 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