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<p>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.</p>

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The impact of social determinants of health on outcomes of brexucabtagene autoleucel in adults with relapsed/refractory B-cell acute lymphoblastic leukemia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月23日

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  • Timothy E. O’Connor,
  • Chenyu Lin,
  • Gregory W. Roloff,
  • Amy Zhang,
  • Katharine Miller,
  • Ibrahim Aldoss,
  • Noam E. Kopmar,
  • Simone E. Dekker,
  • Vishal K. Gupta,
  • Nikeshan Jeyakumar,
  • Ibrahim N. Muhsen,
  • Yannis Valtis,
  • Naveed Ahmed,
  • Katherine Sutherland,
  • Kaitlyn C. Dykes,
  • Mohamed Ahmed,
  • Evan Chen,
  • Hector Zambrano,
  • Danielle Bradshaw,
  • Santiago Mercadal,
  • Marc Schwartz,
  • Sean Tracy,
  • Matthew P. Connor,
  • Michal Kubiak,
  • Akash Mukherjee,
  • Navneet Majhail,
  • Minoo Battiwalla,
  • Luke Mountjoy,
  • Shahbaz A. Malik,
  • John Mathews,
  • Paul Shaughnessy,
  • Betsy Blunk,
  • Aaron C. Logan,
  • Abdullah Ladha,
  • Anjali S. Advani,
  • Maryann Stefan,
  • Caitlin Guzowski,
  • Rasmus T. Hoeg,
  • Talal Hilal,
  • Jozal Moore,
  • Kristen M. O’Dwyer,
  • LaQuisa C. Hill,
  • Joshua Sasine,
  • Caspian Oliai,
  • Melhem M. Solh,
  • Catherine J. Lee,
  • Vamsi K. Kota,
  • Divya Koura,
  • Muthu V. Kumaran,
  • Jessica T. Leonard,
  • Noelle V. Frey,
  • Jae H. Park,
  • Marlise R. Luskin,
  • Veronika Bachanova,
  • Ahmed Galal,
  • Vinod Pullarkat,
  • Michael R. Bishop,
  • Wendy Stock,
  • Ryan D. Cassaday,
  • Bijal D. Shah,
  • Rawan Faramand,
  • Lori S. Muffly,
  • Stephanie B. Tsai,
  • Bhagirathbhai Dholaria

摘要

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.