Study: Poverty Affects Stem Cell Transplant Survival Rate in Children With Cancer

Data show that children with cancer who are experiencing neighborhood poverty and rely on public health insurance have an increased risk of death with stem cell treatment.

Children who receive hematopoietic cell transplant (HTC) as a cancer treatment are more likely to die from treatment-related complications if they live in poorer neighborhoods, according to a study published in Blood.

HTC, also known as stem cell or bone marrow transplants, is used to treat lymphoma and leukemia as well as certain nonmalignant conditions such as sickle cell disease or immunodeficiencies. Combined with radiation or chemotherapy, HTC helps to increase the chance of eliminating the cancerous or abnormal blood cells and restoring normal blood cell production.1

According to the American Society of Hematology (ASH), investigators looked at data from 2053 children with malignant disease and 1696 children with nonmalignant disease who underwent HCT between 2006 and 2015. US Census data was used to determine the neighborhood poverty level, and revealed that 1 in 5 children live in a household below the federal poverty level.

According to investigators, children with cancer living in poorer neighborhoods were more likely to die from treatment-related complications than those who did not. Enrollment in Medicaid was also associated with a 23% increased likelihood of death within 5 years from any cause after undergoing HCT and a 28% greater risk of treatment-related mortality.

According to ASH, the study also showed that among children who received HTC to treat nonmalignant diseases, neither Medicaid nor neighborhood poverty have an impact on outcomes, including overall survival,.

“Our study shows that even after children with cancer have successfully accessed this high-resource treatment at specialized medical centers, those who are exposed to poverty are still at higher risk of dying of complications after treatment and of dying overall,” lead author Kira Bona, MD, MPH said in a prepared statement. “Simply providing the highest quality complex medical care to children who are vulnerable from a social perspective is inadequate if our goal is to cure every child with cancer.”

According to investigators, this study highlights the importance of researching and understanding the social determinants of health on pediatric cancer care. Future studies should focus on more nuanced measures of poverty such as material hardship, and language barriers in order to help mitigate social hardships and improve overall cancer of children with cancer.

REFERENCE

Poverty Linked to Higher Risk of Death Among Children with Cancer Undergoing Stem Cell Transplantation [news release]. Washington, DC; October 28, 2020: ASH. Accessed October 29, 2020. https://www.hematology.org/newsroom/press-releases/2020/poverty-linked-to-higher-risk-of-death-among-children-with-cancer-undergoing-stc