在患有多发性骨髓瘤的老年患者中,治疗和生存的种族差异
Rong Wang1,2, Natalia Neparidze2,3, Xiaomei Ma1,2
1Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA.
Cancer medicine
|January 18, 2024
概括
多发性骨髓瘤治疗的种族差异仍然存在,非西班牙裔非洲裔美国人接受的治疗较少. 然而,他们的死亡率较低,特别是如果没有接受治疗,而接受治疗的患者的生存结果相似.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 健康差异 在健康上的差异
背景情况:
- 多发性骨髓瘤 (MM) 的治疗方法已经进步,改善了生存率.
- 在非西班牙裔非裔美国人 (NHAA) 和非西班牙裔白人 (NHW) 患者之间的MM治疗和预后中存在既定的种族差异.
- 目前尚不清楚这些差异是否仍存在于新型MM药物中.
研究的目的:
- 调查MM诊断后一年内接受MM治疗的种族差异.
- 评估MM的老年医疗保险受益人的生存结果.
- 确定MM治疗和结果的种族差异是否在新药引入后仍然存在.
主要方法:
- 使用了监测,流行病学和最终结果-医疗保险相关数据库.
- 分析的医疗保险受益者 (≥66岁) 在2007-2017年期间被诊断患有MM.
- 应用多变量Cox比例危险模型来估计种族和生存之间的关联.
主要成果:
- 与NHW患者 (64.8%) 相比,NHAA患者 (59.5%) 在第一年内接受治疗的可能性较低.
- 治疗差距从2.9% (2007年至2009年) 扩大到6.9% (2014年至2017年).
- NHAA患者的死亡率较低 (HR=0.94),特别是未接受治疗的患者 (HR=0.84),而接受治疗的NHAA和NHW患者的存活率相似 (p=0.63).
结论:
- 随着时间的推移,MM治疗使用率日益增加的种族差异是一个重大问题.
- 对于识别和消除阻碍NHAA患者获得治疗的障碍至关重要.
- 需要进一步的研究,以了解导致未经治疗的NHAA患者死亡率降低的因素.
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