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Impact of race/ethnicity in the clinical presentation and outcomes of patients with multiple myeloma in an underserved urban population.

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6570 Background: Patients with multiple myeloma (MM) who are part of racial/ethnic minority groups have been typically underrepresented in large descriptive and randomized-controlled studies. Despite the identification of biological and… Click to show full abstract

6570 Background: Patients with multiple myeloma (MM) who are part of racial/ethnic minority groups have been typically underrepresented in large descriptive and randomized-controlled studies. Despite the identification of biological and genetic risk factors, the impact of race/ethnicity in the outcomes of patients with MM remains largely unknown. We aimed to describe the racial/ethnic differences in clinical presentation and outcomes of patients with MM in an ethnically-diverse underserved urban population. Methods: We conducted a single-center retrospective study of patients with MM from Jan 1st 2008 – Dec 31st 2016 using ICD coding from our tumor registry. We abstracted demographic, clinical and treatment variables. We used Chi-square to compare categorical variables and Kaplan-Meier method for survival analysis. Statistical analysis was performed using IBM SPSS version 25. Results: We identified 73 patients with MM with a median follow up time of 42 months (Range 1 to 81 months). Patients had a median age of 59 years (Interquartile Range [IQR] =17) and were predominantly male (54.8%). The most frequent racial/ethnic group was African American (AA) (59%) followed by Hispanic (27%) and Caucasian (8%). When compared to other ethnicities, patients who were AA had higher ISS-3 scores (41% vs 23% p=0.101) worse cytogenetic risk (65% vs 30% p=0.009) and worse response after induction (Complete response [CR] 47% vs 77% p=0.047). They were also more likely to have medical insurance coverage than other ethnicities (67% vs 27% p=0.003) but had similar access to autologous bone marrow transplant (23% vs 23% p= 0.99). Overall, AA patients had worse overall survival (OS) compared to all other ethnic groups (mean OS: 58.3 months vs 79 months p=0.014). Conclusions: AA patients with MM had more aggressive disease and worse OS compared to other ethnicities which may suggest an underlying genetic predisposition towards high-risk genetic features. Improvement of access to autologous bone marrow transplantation may improve survival in high-risk racial/ethnic groups.

Keywords: patients multiple; outcomes patients; multiple myeloma; impact race; racial ethnic; race ethnicity

Journal Title: Journal of Clinical Oncology
Year Published: 2019

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