民族
医学
心理干预
社会经济地位
造血干细胞移植
干预(咨询)
造血干细胞
重症监护医学
卫生公平
移植
衡平法
干细胞
造血
环境卫生
内科学
人口
政治学
公共卫生
病理
精神科
生物
法学
遗传学
作者
Prashanth Ashok Kumar,Krishna Bilas Ghimire,Elio Haroun,Joseph Kassab,Ludovic Saba,Teresa Gentile,Dibyendu Dutta,Seah H. Lim
摘要
Allogeneic hematopoietic stem cell transplant (allo-HSCT) is increasingly being used in the United States (US) and across the world as a curative therapeutic option for patients with certain high-risk hematologic malignancies and non-malignant diseases. However, racial and ethnic disparities in utilization of the procedure and in outcome following transplant remain major problems. Racial and ethnic minority patients are consistently under-represented in the proportion of patients who undergo allo-HSCT in the US. The transplant outcomes in these patients are also inferior. The interrelated driving forces responsible for the differences in the utilization and transplant outcome of the medical intervention are socioeconomic status, complexity of the procedure, geographical barriers, and the results of differences in the genetics and comorbidities across different races. Bridging the disparity gaps is important not only to provide equity and inclusion in the utilization of this potentially life-saving procedure but also in ensuring that minority groups are well represented for research studies about allo-HSCT. This is required to determine interventions that may be more efficacious in particular racial and ethnic groups. Various strategies at the Federal, State, and Program levels have been designed to bridge the disparity gaps with varying successes. In this review paper, we will examine the disparities and discuss the strategies currently available to address the utilization and outcome gaps between patients of different races in the US.
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