What are the ethnic inequities in care outcomes related to haematological malignancies, treated with transplant/cellular-therapies, in the UK?

Abstract

Introduction Haematological cancers are common in the UK, with a variety of morphologies. Stem cell transplants and chimeric antigen receptor (CAR) T-cell therapies provide significant options for hard to treat haematological cancers, although with difficult to predict outcomes. Research into the determinates of treatment efficacy, and access to treatments, is key to ensuring equal benefit across patients, and patient safety. With this, there are concerns about the small representation of minority groups in related research. We aim to report on the current knowledge, to guide future research. Methods and analysis A variety of databases will be searched, for literature on UK minority ethnic populations receiving haematopoietic stem cell transplant or CAR T-cell therapy. Many outcomes will be analysed, covering the patient care pathway for those of the target population, although with a focus on follow-up after therapy. Plans have been made to conduct narrative synthesis, with meta-analysis where applicable. Ethics and Dissemination Outputs will be published in an appropriate journal, and discussed with the wider NIHR Blood and Transplant Research Unit in Precision Transplant and Cellular Therapeutics (BTRU) group. Discussions will also be undertaken with the BTRU patient partners group. Strengths and Limitations of this Study - This systematic review has a detailed search criteria with a variety of search tools, enabling high sensitivity in obtaining evidence. - To enable this work to be completed, reviewers will be working independently on separate reference lists, during screening, rather than voting on the same references and resolving conflicts. To alleviate issues, reviewers will be first required to screen a defined number of papers together, using a more classical approach to confirm agreement, before working independently. - Due to difficulties in pooling together international ethnic groups, only studies in the UK have been included, to reduce complexity. There are some ethnic groups which are more valid to pool together internationally than others, mainly in respect to genetic factors (as opposed to social), which this protocol does not consider.