Overall survival (OS) may be similar between African American, white, and Hispanic patients undergoing therapy for multiple myeloma (MM), according to an analysis of Medicare records published in Blood Advances.
MM makes up approximately 10% of all hematologic malignancies, and nearly 125,000 people in the United States live with the disease. It is, however, more common among African Americans compared with white patients, and the disease biology may be different in different ethnic groups. There is also evidence that black and Hispanic patients have less access to novel therapies for MM and to autologous stem cell transplant (ASCT).
For this study, researchers analyzed data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to compare MM-specific survival, OS, and access to ASCT and novel therapies among African American, Hispanic, and white patients. Patient data from 2007 through 2012 were used.
The researchers included data from 3504 white patients, 858 African American patients, and 468 Hispanic patients. Slightly more than 52% of patients in the white and Hispanic cohorts were male, compared with 40.6% of black patients. White patients were more likely to have a higher socioeconomic status (50.5% in the top 10% income bracket) compared with African American (15.2%) and Hispanic (23.1%) patients. African American and Hispanic patients had higher rates of uncomplicated (44.2% and 42.9%, respectively) and complicated (19.6% and 20.1%, respectively) diabetes compared with white patients (27.9% uncomplicated; 9.2% complicated).
Median OS was similar between the 3 groups, at 2.6 years, 2.5 years, and 2.8 years among white, African American, and Hispanic patients, respectively. Although median MM-specific survival was similar between white (4.5 years) and Hispanic (4.9 years) patients, African American patients had a significantly longer median MM-specific survival (5.4 years).
White patients (2.7 months) had shorter time from diagnosis to novel therapy initiation compared with African American (5.2 months; P <.05) and Hispanic (4.6 months; P <.05) patients. Hispanic patients were also less likely to undergo ASCT compared with African American or white patients (P <.05).
The researchers noted that treatment patterns and economic outcomes varied significantly between different racial and ethnic groups. “Although OS was similar across cohorts, African American and Hispanic patients received novel MM therapies later than white patients and thus may not be reaping the full benefits from the introduction of these treatments,” the researchers wrote.
1. Ailawadhi S, Parikh K, Abouzaid S, et al. Racial disparities in treatment patterns and outcomes among patients with multiple myeloma: a SEER-Medicare analysis [published online October 17, 2019]. Blood Adv. doi:10.1182/bloodadvances.2019000308