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Published on: July 15, 2015
Survival Trends in Young Patients With Multiple Myeloma: A Focus on Racial-Ethnic Minorities
Sikander Ailawadhi1, Abdel-Ghani Azzouqa1, David Hodge2
1Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL.
Introduction:
Outcomes in multiple myeloma (MM) have improved significantly over time. This is true overall for all patients as well as patient subgroups based on age and race/ethnicity. Despite this, disparities are noted in outcomes when looking at racial subgroups.
Materials And Methods:
We performed an analysis from the population-based Surveillance, Epidemiology, and End Results (SEER) database to evaluate improvement in relative survival rates (RSRs) for young (≤ 40 years at the time of MM diagnosis) and older (> 40 years at the time of MM diagnosis) over time by race/ethnicity, specifically focusing on Hispanic patients with MM. Expected survival was estimated using the age- and gender-specific death rates from the United States population. RSR was provided as the ratio of the observed to expected survival at individual time points. Five-year and 10-year RSRs were calculated for patients based on treatments modalities available in various time periods.
Results:
We identified a total of 89,451 patients with MM in SEER, of which 1460 patients formed the young patients with MM (≤ 40 years) cohort. Five- and 10-year RSR improved significantly over time for all patients and older patients (> 40 years) by race (all P < .001). Evaluating the younger patients, RSR improved significantly for non-Hispanic whites and non-Hispanic blacks, but not for Hispanics. This was true for the 5-year (P = .08) and 10-year (P = .13) RSRs.
Conclusion:
We report a lack of significant benefit in long-term outcomes for younger Hispanic patients with MM over time. This could be owing to multifactorial causes that need to be addressed to mitigate outcome disparities.
Insights
Younger Hispanic patients with multiple myeloma (MM) show no significant improvement in long-term survival rates over time. This highlights critical disparities that need to be addressed to improve outcomes for this specific population.
Area of Science:
- Hematology
- Oncology
- Epidemiology
Background:
- Multiple myeloma (MM) outcomes have improved, yet racial disparities persist.
- Survival improvements are noted across age and race/ethnicity subgroups.
- Specific focus on Hispanic MM patients is crucial for understanding outcome gaps.
Purpose of the Study:
- To analyze trends in relative survival rates (RSRs) for young (≤40 years) and older (>40 years) MM patients.
- To evaluate RSR improvements over time stratified by race/ethnicity, with a focus on Hispanic patients.
- To identify disparities in MM outcomes among different racial and age groups.
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) database for population-based analysis.
- Calculated 5- and 10-year RSRs by comparing observed survival to expected survival.
- Stratified analysis by age (≤40 vs. >40 years) and race/ethnicity, including Hispanic patients.
Main Results:
- Overall survival rates significantly improved for all MM patients and older adults across racial groups.
- Younger non-Hispanic white and Black MM patients demonstrated significant RSR improvements.
- Younger Hispanic MM patients did not show a statistically significant improvement in 5- or 10-year RSRs over time.
Conclusions:
- A lack of significant long-term outcome improvement was observed in younger Hispanic MM patients.
- Multifactorial causes likely contribute to these observed outcome disparities.
- Addressing these disparities is essential for mitigating inequities in MM care.
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