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

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; La Quisa 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

doi:10.1038/s41409-025-02693-0

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

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 MercadalMarc 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, La Quisa 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

Medicine - Hematology, Oncology, Transplant

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English (US)
Pages (from-to)	1465-1471
Number of pages	7
Journal	Bone marrow transplantation
Volume	60
Issue number	11
DOIs	https://doi.org/10.1038/s41409-025-02693-0
State	Published - Nov 2025

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Publisher Copyright:
© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2025.

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O’Connor, T. E., Lin, C., Roloff, G. W., Zhang, A., Miller, K., Aldoss, I., Kopmar, N. E., Dekker, S. E., Gupta, V. K., Jeyakumar, N., Muhsen, I. N., Valtis, Y., Ahmed, N., Sutherland, K., Dykes, K. C., Ahmed, M., Chen, E., Zambrano, H., Bradshaw, D., ... Dholaria, B. (2025). The impact of social determinants of health on outcomes of brexucabtagene autoleucel in adults with relapsed/refractory B-cell acute lymphoblastic leukemia. Bone marrow transplantation, 60(11), 1465-1471. https://doi.org/10.1038/s41409-025-02693-0

O’Connor, TE, Lin, C, Roloff, GW, Zhang, A, Miller, K, Aldoss, I, Kopmar, NE, Dekker, SE, Gupta, VK, Jeyakumar, N, Muhsen, IN, Valtis, Y, Ahmed, N, Sutherland, K, Dykes, KC, Ahmed, M, Chen, E, Zambrano, H, Bradshaw, D, Mercadal, S, Schwartz, M, Tracy, S, Connor, MP, Kubiak, M, Mukherjee, A, Majhail, N, Battiwalla, M, Mountjoy, L, Malik, SA, Mathews, J, Shaughnessy, P, Blunk, B, Logan, AC, Ladha, A, Advani, AS, Stefan, M, Guzowski, C, Hoeg, RT, Hilal, T, Moore, J, O’Dwyer, KM, Hill, LQC, Sasine, J, Oliai, C, Solh, MM, Lee, CJ, Kota, VK, Koura, D, Kumaran, MV, Leonard, JT, Frey, NV, Park, JH, Luskin, MR, Bachanova, V, Galal, A, Pullarkat, V, Bishop, MR, Stock, W, Cassaday, RD, Shah, BD, Faramand, R, Muffly, LS, Tsai, SB & Dholaria, B 2025, 'The impact of social determinants of health on outcomes of brexucabtagene autoleucel in adults with relapsed/refractory B-cell acute lymphoblastic leukemia', Bone marrow transplantation, vol. 60, no. 11, pp. 1465-1471. https://doi.org/10.1038/s41409-025-02693-0

@article{b858fe43d4454d3d82395f49059e1cd3,

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

abstract = "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.",

author = "O{\textquoteright}Connor, \{Timothy E.\} and Chenyu Lin and Roloff, \{Gregory W.\} and Amy Zhang and Katharine Miller and Ibrahim Aldoss and Kopmar, \{Noam E.\} and Dekker, \{Simone E.\} and Gupta, \{Vishal K.\} and Nikeshan Jeyakumar and Muhsen, \{Ibrahim N.\} and Yannis Valtis and Naveed Ahmed and Katherine Sutherland and Dykes, \{Kaitlyn C.\} and Mohamed Ahmed and Evan Chen and Hector Zambrano and Danielle Bradshaw and Santiago Mercadal and Marc Schwartz and Sean Tracy and Connor, \{Matthew P.\} and Michal Kubiak and Akash Mukherjee and Navneet Majhail and Minoo Battiwalla and Luke Mountjoy and Malik, \{Shahbaz A.\} and John Mathews and Paul Shaughnessy and Betsy Blunk and Logan, \{Aaron C.\} and Abdullah Ladha and Advani, \{Anjali S.\} and Maryann Stefan and Caitlin Guzowski and Hoeg, \{Rasmus T.\} and Talal Hilal and Jozal Moore and O{\textquoteright}Dwyer, \{Kristen M.\} and Hill, \{La Quisa C.\} and Joshua Sasine and Caspian Oliai and Solh, \{Melhem M.\} and Lee, \{Catherine J.\} and Kota, \{Vamsi K.\} and Divya Koura and Kumaran, \{Muthu V.\} and Leonard, \{Jessica T.\} and Frey, \{Noelle V.\} and Park, \{Jae H.\} and Luskin, \{Marlise R.\} and Veronika Bachanova and Ahmed Galal and Vinod Pullarkat and Bishop, \{Michael R.\} and Wendy Stock and Cassaday, \{Ryan D.\} and Shah, \{Bijal D.\} and Rawan Faramand and Muffly, \{Lori S.\} and Tsai, \{Stephanie B.\} and Bhagirathbhai Dholaria",

note = "Publisher Copyright: {\textcopyright} This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2025.",

year = "2025",

month = nov,

doi = "10.1038/s41409-025-02693-0",

language = "English (US)",

volume = "60",

pages = "1465--1471",

journal = "Bone marrow transplantation",

issn = "0268-3369",

publisher = "Springer Nature",

number = "11",

}

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T1 - The impact of social determinants of health on outcomes of brexucabtagene autoleucel in adults with relapsed/refractory B-cell acute lymphoblastic leukemia

AU - O’Connor, Timothy E.

AU - Lin, Chenyu

AU - Roloff, Gregory W.

AU - Zhang, Amy

AU - Miller, Katharine

AU - Aldoss, Ibrahim

AU - Kopmar, Noam E.

AU - Dekker, Simone E.

AU - Gupta, Vishal K.

AU - Jeyakumar, Nikeshan

AU - Muhsen, Ibrahim N.

AU - Valtis, Yannis

AU - Ahmed, Naveed

AU - Sutherland, Katherine

AU - Dykes, Kaitlyn C.

AU - Ahmed, Mohamed

AU - Chen, Evan

AU - Zambrano, Hector

AU - Bradshaw, Danielle

AU - Mercadal, Santiago

AU - Schwartz, Marc

AU - Tracy, Sean

AU - Connor, Matthew P.

AU - Kubiak, Michal

AU - Mukherjee, Akash

AU - Majhail, Navneet

AU - Battiwalla, Minoo

AU - Mountjoy, Luke

AU - Malik, Shahbaz A.

AU - Mathews, John

AU - Shaughnessy, Paul

AU - Blunk, Betsy

AU - Logan, Aaron C.

AU - Ladha, Abdullah

AU - Advani, Anjali S.

AU - Stefan, Maryann

AU - Guzowski, Caitlin

AU - Hoeg, Rasmus T.

AU - Hilal, Talal

AU - Moore, Jozal

AU - O’Dwyer, Kristen M.

AU - Hill, La Quisa C.

AU - Sasine, Joshua

AU - Oliai, Caspian

AU - Solh, Melhem M.

AU - Lee, Catherine J.

AU - Kota, Vamsi K.

AU - Koura, Divya

AU - Kumaran, Muthu V.

AU - Leonard, Jessica T.

AU - Frey, Noelle V.

AU - Park, Jae H.

AU - Luskin, Marlise R.

AU - Bachanova, Veronika

AU - Galal, Ahmed

AU - Pullarkat, Vinod

AU - Bishop, Michael R.

AU - Stock, Wendy

AU - Cassaday, Ryan D.

AU - Shah, Bijal D.

AU - Faramand, Rawan

AU - Muffly, Lori S.

AU - Tsai, Stephanie B.

AU - Dholaria, Bhagirathbhai

PY - 2025/11

Y1 - 2025/11

N2 - 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.

AB - 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.

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AN - SCOPUS:105013810603

SN - 0268-3369

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JO - Bone marrow transplantation

JF - Bone marrow transplantation

IS - 11

ER -

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

Abstract

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