TY - JOUR
T1 - Association of Human Development Index with rates and outcomes of hematopoietic stem cell transplantation for patients with acute leukemia
AU - Giebel, Sebastian
AU - Labopin, Myriam
AU - Ehninger, Gerhard
AU - Beelen, Dietrich
AU - Blaise, Didier
AU - Ganser, Arnold
AU - Bacigalupo, Andrea
AU - Czerw, Tomasz
AU - Holowiecki, Jerzy
AU - Fagundes, Evandro M.
AU - Nowara, Elzbieta
AU - Frassoni, Francesco
AU - Rocha, Vanderson
PY - 2010/7/8
Y1 - 2010/7/8
N2 - Human Development Index (HDI) is used by the United Nations Organization to measure socioeconomic achievements of countries. We evaluated the association of HDI with rates and outcomes of hematopoietic stem cell transplantation (HSCT) for patients with acute leukemia. For the analysis of HSCT rates, all adults with acute leukemia (n = 16 403) treated in 30 European countries, between 2001 and 2005, were included. Association of HDI with the outcome was analyzed for 2015 patients with acute myeloid leukemia treated with myeloablative allotransplantation. Countries were classified according to HDI quintiles. Highly significant correlation was found for HDI and the total number of HSCT per population (R = 0.78; P <.001), as well as separately for sibling HSCT (R = 0.84; P <.001), unrelated HSCT (R = 0.66; P <.001), and autologous HSCT (R = 0.43; P = .02). The probabilities of leukemia-free survival for 5 consecutive groups of countries with increasing HDI were: 56%, 59%, 63%, 58%, and 68% (P = .01). In a multivariate analysis, transplantations performed in countries belonging to the upper HDI category were associated with higher leukemia-free survival compared with the remaining ones (HR = 1.36, P = .008), which resulted mainly from reduced risk of relapse (HR = 0.72, P = .04). We conclude that, in Europe, the HDI is associated with both rates and results of HSCT for acute leukemia.
AB - Human Development Index (HDI) is used by the United Nations Organization to measure socioeconomic achievements of countries. We evaluated the association of HDI with rates and outcomes of hematopoietic stem cell transplantation (HSCT) for patients with acute leukemia. For the analysis of HSCT rates, all adults with acute leukemia (n = 16 403) treated in 30 European countries, between 2001 and 2005, were included. Association of HDI with the outcome was analyzed for 2015 patients with acute myeloid leukemia treated with myeloablative allotransplantation. Countries were classified according to HDI quintiles. Highly significant correlation was found for HDI and the total number of HSCT per population (R = 0.78; P <.001), as well as separately for sibling HSCT (R = 0.84; P <.001), unrelated HSCT (R = 0.66; P <.001), and autologous HSCT (R = 0.43; P = .02). The probabilities of leukemia-free survival for 5 consecutive groups of countries with increasing HDI were: 56%, 59%, 63%, 58%, and 68% (P = .01). In a multivariate analysis, transplantations performed in countries belonging to the upper HDI category were associated with higher leukemia-free survival compared with the remaining ones (HR = 1.36, P = .008), which resulted mainly from reduced risk of relapse (HR = 0.72, P = .04). We conclude that, in Europe, the HDI is associated with both rates and results of HSCT for acute leukemia.
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U2 - 10.1182/blood-2010-01-266478
DO - 10.1182/blood-2010-01-266478
M3 - Article
C2 - 20395416
AN - SCOPUS:77955945641
VL - 116
SP - 122
EP - 128
JO - Blood
JF - Blood
SN - 0006-4971
IS - 1
ER -