Dissecting racial disparities in multiple myeloma

Area of Science:

• Hematology
• Oncology
• Epidemiology

Background:

• Multiple myeloma (MM) is a fatal plasma cell cancer that progresses from precursor conditions like monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM).
• Significant racial disparities exist in MM incidence, mortality, and survival, with Black individuals experiencing a disproportionately higher burden compared to White individuals.
• These disparities have persisted despite overall survival improvements in MM treatment.

Purpose of the Study:

• To investigate the multifactorial nature of racial disparities in multiple myeloma (MM) across its disease continuum.
• To explore differences in risk factors, biology, and clinical characteristics between Black and White patients with MGUS and MM.
• To identify barriers to MM care and survival, emphasizing the need for improved understanding and elimination of these disparities.

Main Methods:

• Comparative analysis of risk factors, biological markers, and clinical characteristics across racial groups in MGUS and MM.
• Review of existing clinical and epidemiological studies focusing on racial disparities in MM.
• Assessment of treatment utilization and access as potential contributors to survival differences.

Main Results:

• Black individuals exhibit increased risk and mortality for MGUS and MM compared to White individuals.
• Differences in risk factors, biology, and clinical presentation by race suggest a complex etiology for MM disparities.
• Limited accrual of Black patients in studies hinders a comprehensive understanding of these disparities.
• Survival disparities appear linked to inferior treatment access and utilization rather than solely pathogenesis.

Conclusions:

• Racial disparities in MM are multifactorial, involving differences in risk, biology, and clinical presentation.
• Addressing disparities requires enhanced understanding of MM across its continuum, from MGUS to overt MM.
• Innovative, multidisciplinary approaches are crucial to eliminate racial disparities in MM care and improve outcomes for all patients.