Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2020 Aug 7;10(8):80.
doi: 10.1038/s41408-020-00347-6.

Racial differences in treatment and outcomes in multiple myeloma: a multiple myeloma research foundation analysis

Benjamin A Derman  1 , Jagoda Jasielec  2 , Spencer S Langerman  3 , Wei Zhang  4 , Andrzej J Jakubowiak  2 , Brian C-H Chiu  3
Affiliations
Observational Study

Racial differences in treatment and outcomes in multiple myeloma: a multiple myeloma research foundation analysis

Benjamin A Derman et al. Blood Cancer J. .

Abstract

Findings on racial differences in survival in multiple myeloma (MM) have been inconclusive. We assessed differences in outcomes between White and Black individuals among 639 newly diagnosed MM patients in the MM Research Foundation CoMMpass registry with baseline cytogenetic data. Survival curves were constructed using the Kaplan-Meier method. Hazard ratios and 95% confidence intervals were derived from Cox proportional hazard regression models. Age, gender, and stage were similar between Whites (n = 526) and Blacks (n = 113). Blacks had inferior overall survival (OS) compared with Whites and were less likely to receive triplet therapies or frontline autologous stem cell transplant (ASCT). The following factors were significantly associated with inferior OS in multivariate analysis: higher international staging system (ISS) score, ≥1 or ≥2 high-risk cytogenetic abnormalities (HRCA), high-risk gene expression profile (GEP), and lack of ASCT. Multivariate analysis in the Black subset found that only lack of ASCT was significantly associated with inferior OS. The receipt of both triplet induction and ASCT only partly abrogated the effect of race on survival. HRCA did not track with survival in Blacks, emphasizing the need for race-specific risk prognostication schema to guide optimal MM therapy.

PubMed Disclaimer

Conflict of interest statement

B.A.D., J.J., S.L., W.Z., A.J.J., and B.C.H.C. declare no competing interests. The University of Chicago is a member of the Multiple Myeloma Research Consortium.

Figures

Fig. 1
Fig. 1. Overall survival stratified By race.
Overall survival was shorter for Blacks compared with Whites, with an age-adjusted hazard ratio of 1.7 (95% confidence interval 1.2–2.4, p = 0.003).
Fig. 2
Fig. 2. Overall survival of patients receiving triplet therapy and autologous transplant stratified by race.
The difference in OS between races was partly attenuated in patients receiving triplet therapy and autologous stem cell transplant.
See this image and copyright information in PMC

References

    1. Howlader, N. et al. SEER Cancer Statistics Review, 1975–2017 (National Cancer Institute, Bethesda, MD, 2019).
    1. Waxman AJ, et al. Racial disparities in incidence and outcome in multiple myeloma: a population-based study. Blood. 2010;116:5501–5506. - PMC - PubMed
    1. Landgren O, et al. Risk of monoclonal gammopathy of undetermined significance (MGUS) and subsequent multiple myeloma among African American and white veterans in the United States. Blood. 2006;107:904–906. - PMC - PubMed
    1. Landgren O, et al. Prevalence of monoclonal gammopathy of undetermined significance among men in Ghana. Mayo Clin. Proc. 2007;82:1468–1473. - PubMed
    1. Konstantinopoulos PA, Pantanowitz L, Dezube BJ. Higher prevalence of monoclonal gammopathy of undetermined significance in African Americans than whites–the unknown role of underlying HIV infection. J. Natl Med. Assoc. 2006;98:1860–1861. - PMC - PubMed

Publication types