The role of socioeconomic deprivation on inequities in care outcomes of haematological malignancies, treated with stem cell transplant in the UK: A systematic Review Protocol

IntroductionStem cell transplant (SCT) is a potential cure for haematological malignancies whose outcomes are predicted to be poor on chemotherapy alone and cases difficult to treat using standard of care treatment. There is growing evidence to show that not all patients who would benefit from SCT, receive it due to inequities in the treatment pathway. The role of socioeconomic deprivation on inequities in the SCT setting is unclear due to conflicting findings. We aim to synthesis the UK evidence base in this area to guide further research and policy to improve survival for underserved patients. Method and analysisPrimary electronic searches will be performed in bibliographic databases including MEDLINE, Embase, Proquest Databases, Central & CDSR, Stem Cell Evidence and Web of Science and Google Scholar for grey literature. Eligibility criteria will include observational studies of UK patients diagnosed with haematological malignancies, treated with SCT, where outcomes are reported according to socioeconomic deprivation. Two independent reviewers will screen each study and assess the quality of all included studies be using the Newcastle-Ottawa grading system. Outcomes of interest include delay in diagnosis/referral, treatments/interventions received, referral to transplant, presence of co-morbidities affecting transplant eligibility, access to transplant, transplant utilisation rates, waiting time to transplant and survival rates. Inequities in SCT due to socioeconomic deprivation will be narratively summarised. Meta-analysis will be conducted dependent on data availability. This protocol has been registered with PROSPERO (2024: CRD42024620592). Ethics and disseminationEthical approval is not required for this study as it is a secondary analysis of published data. The findings will be submitted for peer-reviewed publication, shared at conference presentations, and disseminated to both clinical and patient groups including National (Black, Asian, Mixed Race, and Minority Ethnic) BAME Transplant Alliance (NBTA) and the National Institute for Health Research (NIHR) Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics. Article SummaryO_ST_ABSStrengths and limitations of this studyC_ST_ABSO_LIThis review will provide the first comprehensive and systematic summary of inequities due to socioeconomic deprivation in the stem cell transplant setting in the UK, following the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines C_LIO_LIThis review will focus on data collected from studies performed in a UK population only. The findings can be applied to a UK population but application to other countries will be limited. C_LIO_LIPatients and the public participated in the development of the review and will support interpretation of findings and dissemination to the wider public. C_LI