The impact of social determinants of health on outcomes of brexucabtagene autoleucel in adults with relapsed/refractory B-cell acute lymphoblastic leukemia Journal Article
| Authors: | O'Connor, T. E.; Lin, C. Y.; Roloff, G. W.; Zhang, A.; Miller, K.; Aldoss, I.; Kopmar, N. E.; Dekker, S. E.; Gupta, V. K.; Jeyakumar, N.; Muhsen, I. N.; Valtis, Y.; Ahmed, N.; Sutherland, K.; Dykes, K. C.; Ahmed, M.; Chen, E.; Zambrano, H.; Bradshaw, D.; Mercadal, S.; Schwartz, M.; Tracy, S.; Connor, M. P.; Kubiak, M.; Mukherjee, A.; Majhail, N.; Battiwalla, M.; Mountjoy, L.; Malik, S. A.; Mathews, J.; Shaughnessy, P.; Blunk, B.; Logan, A. C.; Ladha, A.; Advani, A. S.; Stefan, M.; Guzowski, C.; Hoeg, R. T.; Hilal, T.; Moore, J.; O'Dwyer, K. M.; Hill, L. C.; Sasine, J.; Oliai, C.; Solh, M. M.; Lee, C. J.; Kota, V. K.; Koura, D.; Kumaran, M. V.; Leonard, J. T.; Frey, N. V.; Park, J. H.; Luskin, M. R.; Bachanova, V.; Galal, A.; Pullarkat, V.; Bishop, M. R.; Stock, W.; Cassaday, R. D.; Shah, B. D.; Faramand, R.; Muffly, L. S.; Tsai, S. B.; Dholaria, B. |
| Article Title: | The impact of social determinants of health on outcomes of brexucabtagene autoleucel in adults with relapsed/refractory B-cell acute lymphoblastic leukemia |
| Abstract: | Brexucabtagene autoleucel (brexu-cel) is a chimeric antigen receptor T (CAR T) cell therapy approved for adults with relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL). We studied the impact of social determinants of health (SDoH) on outcomes of adults with B-ALL receiving brexu-cel. This retrospective analysis included adults (>= 18 years) with R/R B-ALL treated with brexu-cel between 2021 and 2023. Cox proportional hazards models evaluated the association of race, ethnicity, and SDoH with progression-free survival (PFS) and overall survival (OS). 189 patients received brexu-cel and 57% were male. 55% were non-Hispanic White, 30% Hispanic, 7% non-Hispanic Black, 6% Asian/Pacific Islander, and 2% other/unknown. 43% were referred from private/community-based practices and 35% lived 50 miles or greater from the CAR T center. Health insurance included public (47%) and private (41%). 31% had a high social deprivation index (SDI, 76-99th percentile). Black race was associated with worse OS (HR 3.48; 95% CI 1.01-12.03). There was no difference in PFS (HR 1.03, 95% CI 0.50-2.10) or OS (HR 1.43; 95% CI 0.56-3.65) in Hispanic patients. Outcomes appear independent of SDoH and SDoH did not impact OS. We observed comparable outcomes to non-Hispanic patients. |
| Keywords: | survival; insurance; therapy; race; disease; united-states; barriers; disparities; ethnic-differences; cancer |
| Journal Title: | Bone Marrow Transplantation |
| ISSN: | 0268-3369 |
| Publisher: | Nature Publishing Group |
| Publication status: | Online ahead of print |
| Date Published: | 2025-01-01 |
| Online Publication Date: | 2025-01-01 |
| Language: | English |
| ACCESSION: | WOS:001555502400001 |
| DOI: | 10.1038/s41409-025-02693-0 |
| PROVIDER: | wos |
| Notes: | Article; Early Access -- Source: Wos |
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