Survival Trends in Young Patients With Multiple Myeloma: A Focus on Racial-Ethnic Minorities

Clin Lymphoma Myeloma Leuk. 2019 Oct;19(10):619-623. doi: 10.1016/j.clml.2019.06.010. Epub 2019 Jun 26.

Abstract

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.

Keywords: Age-related survival; Disparity; Inequity in healthcare; Outcomes; Time-related trend.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Asian People / statistics & numerical data
  • Black or African American / statistics & numerical data
  • Cohort Studies
  • Female
  • Healthcare Disparities / statistics & numerical data*
  • Healthcare Disparities / trends
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / ethnology
  • Multiple Myeloma / therapy*
  • Population Surveillance / methods*
  • SEER Program / statistics & numerical data*
  • United States
  • White People / statistics & numerical data