{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:29:30Z","timestamp":1788445770221,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Limited English proficiency (LEP) is associated with adverse clinical outcomes. The clinical impact of LEP in hematopoietic stem cell transplant (HSCT) has not been studied. The objectives of this study were to compare HSCT outcomes and health care utilization of Hispanic pediatric patients with and without parental LEP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective review of Hispanic\/Latino pediatric patients receiving HSCT at a single institution. Families were identified as LEP or English proficient (EP) based on clinicians\u2019 notes, social work documentation, or the signature of a Spanish interpreter on treatment consents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 83 Hispanic\/Latino patients were identified with 53 (65.1%) having parental LEP. More patients in the LEP group had a documented financial burden at pretransplant psychosocial evaluation (72.2% vs. 41.4%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.009). LEP patients were more likely to have health insurance coverage through government\u2010sponsored Medicaid (76.9% vs. 27.6%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). LEP patients were hospitalized on average 13\u00a0days longer than EP patients, and LEP patients were more likely to have pretransplant cytomegalovirus (CMV) reactivity (67.3%) than EP patients (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.001). Overall survival was lower in LEP than EP, but was not statistically significant (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.193). Multivariable Cox modeling suggested a potentially higher risk of death in LEP versus EP (hazard ratio\u00a0=\u00a01.56, 95% CI: 0.38, 6.23).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Parental LEP in HSCT is associated with prolonged hospitalization and pretransplant CMV reactivity. These factors are associated with posttransplant complications and death. Our results suggest parental LEP is a risk factor for poor HSCT outcomes. Further study is warranted in a larger cohort.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.29174","type":"journal-article","created":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T21:18:55Z","timestamp":1623359935000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Parental limited English proficiency in pediatric stem cell transplantation: Clinical impact and health care utilization"],"prefix":"10.1002","volume":"68","author":[{"given":"Joanna M.","family":"Robles","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology Oncology Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse D.","family":"Troy","sequence":"additional","affiliation":[{"name":"Pediatric Transplant and Cellular Therapy Division Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin M.","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology Oncology Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul L.","family":"Martin","sequence":"additional","affiliation":[{"name":"Pediatric Transplant and Cellular Therapy Division Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W.","family":"LeBlanc","sequence":"additional","affiliation":[{"name":"Division of Hematologic Malignancies and Cellular Therapy Duke Cancer Institute  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"The Annie E.Casey Foundation. Kids Count Data Center.Children in Immigrant Families in the United States.https:\/\/datacenter.kidscount.org\/data\/tables\/115\u2010children\u2010in\u2010immigrant\u2010families?loc=1&loct=1#detailed\/1\/any\/false\/871 870 573 869 36 868 867 133 38 35\/any\/445 446Published 2020. Updated January 2020. Accessed April 23 2020."},{"key":"e_1_2_9_3_1","unstructured":"Institute U.Children of Immigrants Data Tool.2020.http:\/\/webapp.urban.org\/charts\/datatool\/pages.cfm. Published 2020. Accessed April 23 2020."},{"key":"e_1_2_9_4_1","unstructured":"Bureau UC.Detailed Languages Spoken at Home and Ability to Speak English for the Population 5 Years and Over: 2009\u20132013.https:\/\/www.census.gov\/data\/tables\/2013\/demo\/2009\u20102013\u2010lang\u2010tables.html. Published 2015. 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