Racial and socioeconomic disparities in patients with Waldenström Macroglobulinemia: a SEER database analysis

Waldenström Macroglobulinemia (WM) is a rare plasma cell disorder with a prolonged smoldering phase, and treatment initiation is typically delayed. While multiple therapeutic options exist for WM, it remains unclear whether minoritized and low socioeconomic status (SES) patients experience equal or similar survival outcomes. We conducted a retrospective study using the SEER database, identifying WM patients diagnosed between 2006 and 2020. We examined overall survival (OS) and cancer-specific survival (CSS) disparities in 8256 WM patients by race/ethnicity and SES, as defined by the Yost index. Race/ethnicity was categorized as Non-Hispanic White (NHW), Non-Hispanic Black (NHB), Hispanic, and Non-Hispanic Other. Logistic regression showed that lower SES was associated with greater chemotherapy use (OR = 1.33, 95% CI, 1.22-1.46). Low SES was linked to increased all-cause mortality (HR = 1.37, 95% CI, 1.27-1.47). In stratified analyses, low SES was associated with worse OS in NHW and Hispanic patients but not in NHB patients. No differences in CSS were seen between low and high SES groups in the univariate Cox regression. However, after adjustment and competing risk analysis low SES patients had worse CSS. These findings suggest that SES is associated with survival disparities in WM, underscoring the critical role of addressing social determinants of health to ensure equitable outcomes.