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Updated: Aug 6, 2026
09:41
An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
Published on: July 15, 2015
Evolution of Real-World Front-Line Treatment Patterns in Multiple Myeloma
Alexander Lazzaro1, Kaelyn Nannini2, Cenk Yildirim3
1Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, Massachusetts, United States.
Blood Advances
|July 21, 2026
Summary
Novel treatments have improved multiple myeloma (MM) survival, but outcomes vary by socioeconomic status. Even with equal access in the VA system, lower socioeconomic status patients face higher mortality, highlighting the need to address social barriers in MM care.
Area of Science:
- Hematology
- Oncology
- Health Services Research
Background:
- Multiple myeloma (MM) treatments have advanced significantly, increasing complexity in clinical decision-making.
- Despite improved survival with novel therapies, these benefits are not equally distributed across all patient populations.
- Randomized clinical trials often exclude diverse patient groups, limiting the generalizability of findings to real-world outcomes.
Purpose of the Study:
- To analyze trends in multiple myeloma treatment patterns and outcomes within the Veterans Affairs (VA) health system.
- To investigate the impact of sociodemographic factors, particularly socioeconomic status, on MM survival.
- To understand how treatment decisions and outcomes have evolved over time in a large, diverse patient cohort.
Main Methods:
- Retrospective analysis of 20,135 patients with newly diagnosed MM from the VA health system (2000-2024).
- Evaluation of overall survival (OS) stratified by treatment regimen, diagnosis era, and sociodemographic features.
- Assessment of socioeconomic status using the area deprivation index (ADI) to approximate disparities.
Main Results:
- Overall survival for MM has improved across different treatment eras.
- Lower socioeconomic status, indicated by higher ADI, was independently associated with increased mortality, even within the VA's equal access setting.
- Treatment decisions and adoption of new agents show variability in clinical practice.
Conclusions:
- While novel therapies have improved MM outcomes, disparities persist, particularly linked to socioeconomic status.
- Addressing structural and social barriers is crucial for achieving equitable optimal care for all multiple myeloma patients.
- Long-term survival in the most recent MM treatment era requires further characterization.
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