Factors Associated with Clinical Trial Participation in Adult Hematopoietic Stem Cell Transplantation (HSCT) Recipients: A Center for International Blood and Marrow Transplant Research (CIBMTR) Analysis
Bibliographic record
Abstract
Topic Significance & Study Purpose/Background/Rationale Only 3-5% of adults with cancer enroll in clinical trials nationwide. While clinical trial participation in solid tumors is well-studied, little is known about clinical trial participation in the context of HSCT. Methods, Intervention, & Analysis Retrospective cohort study to: (1) describe clinical trial participation rates by HSCT type; (2) examine associations between patient, disease, and transplant-related characteristics and trial participation; and (3) explore the association between trial participation and overall survival (OS). Multivariable logistic and Cox regression models were used to examine associations and were stratified by transplant center and HSCT year to adjust for trial availability. Findings & Interpretation We analyzed CIBMTR data collected between 2013 and 2019 that included 84,151 adult HSCT recipients (autologous: n=51,133; allogeneic: n=33,018). The proportion of patients who participated in a clinical trial was 16.2% in allogeneic HSCT and 2.8% in autologous HSCT. In allogeneic HSCT, older age (ages 60-69: OR = 1.92, p =0.0003), and age ≥ 70 ( OR = 2.19, p<0.0001), Black race (OR = 1.35, p =0.0002), cord blood transplant (OR = 3.19, p <0.0001), MMUD (OR = 2.04, p =0.0017), intermediate disease risk (OR = 1.23, p = 0.007), a diagnosis of sickle cell disease (OR = 2.64, p <0.0001) were associated with higher odds of participation. In contrast, a diagnosis of severe aplastic anemia (OR = 0.32, p <0.0001), receipt of peripheral blood stem cells (OR = 0.46, P<0.0001) and haploidentical donors (OR= 0.49, P<0.0001) were associated with lower odds of participation. In autologous HCT, ≥3 comorbidities were associated with lower odds of participation (3: OR = 0.65, p = 0.0003; 4: OR = 0.54, p <0.0001; 5≥: OR = 0.53, p <0.0001). Compared to Hodgkin disease, plasma cell disorders/MM (OR 1.74, p = 0.0009) had higher odds of participation. Clinical trial participation was not associated with OS for allogeneic (HR=0.97, p = 0.37) or autologous (HR=1.09, p = 0.25) HSCT. Discussion & Implications A greater proportion of allogeneic compared to autologous HSCT recipients participated in a clinical trial with no difference in survival. Multiple patient, disease, and transplant-related characteristics were associated with clinical trial participation, warranting further investigation.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".