A Review of Disparities in Autologous Stem Cell Transplantation in Patients with Relapsed/Refractory Diffuse Large B-cell Lymphoma.

[INTRODUCTION] Among patients with diffuse large B-cell lymphoma (DLBCL), up to 50% of patients will develop relapsed or refractory (R/R) disease. One standard approach to R/R DLBCL is high-dose chemotherapy with autologous stem cell transplantation (autoSCT). A significant number of patients with R/R DLBCL, however, will not receive autoSCT. This study identifies disparities in autoSCT for R/R DLBCL.

[AREAS COVERED] Articles published between 2000 and 2025 detailing disparities and barriers to autoSCT in DLBCL were identified using PubMed and Google Scholar, using predefined keywords related to autologous stem cell transplantation, DLBCL, and access barriers. Eligible qualitative, cross-sectional, observational, and interventional studies involving adults with hematologic malignancies were screened. Eighteen articles were selected. Disparities fell into eight categories: race/ethnicity; sex; socioeconomic status; health insurance; comorbidities, performance status, and age; social factors; treatment center; distance to treatment center.

[EXPERT OPINION] Disparities in the access and utilization of autoSCT including age, sociodemographic factors, and type of treatment center, are often intertwined. The impact of the financial costs of autoSCT is significant for patients and caregivers. This review underscores persistent disparities in cellular therapies for R/R DLBCL. We must identify these disparities and implement changes to improve access and utilization of these potentially curative therapies.