INTRODUCTION
It’s widely documented that racial disparities exist between White and African Americans (AA) with multiple myeloma (MM) resulting in an inferior outcome among AA. A Veterans Administration study of MM patients showed that with equal access, AA have superior survival compared to Whites. Autologous hematopoietic stem cell transplant (AHST) is a standard treatment modality and improves survival but only 20% of AA receive AHST compared to 39% for Whites.
METHODS
Beginning July 2017, we embarked on a program of outreach to market our transplant and hematologic malignancy program with the intention of increasing patient referrals and transplant volumes. In early 2019, we started satellite clinics in two large community practices; practice A 65 miles and practice B 89 miles from our center. Patients that required a transplant received induction treatment and a full pre-transplant work up at their respective satellite clinics to minimize travel and make it more feasible for patients and families. In this analysis, we only included patients with MM who received a transplant.
RESULTS
Between 2013 and June, 2017 (no outreach and no satellite clinics) our transplant center performed 81 MM transplants and 300 from July 2017 to December 2023. Before starting outreach and satellite clinics there were 2 transplants from practice A and 0 from practice B. From July 2017 to December 2023 there were 72 transplants; 48 from practice A and 24 from practice B. 61.1% of patients identified as AA and 37.5% as White. The median distance from the patients’ homes to our transplant center was 85.25 and 94.95miles respectively. 32 patients had Medicare and 40 private insurance.
CONCLUSIONS
We concluded that outreach, with meticulous communication, increases MM transplant referrals. More importantly, setting up satellite clinics is a highly effective initiative and will not only increase transplant referrals, but most notably increases AHST access to AA.
