Socioeconomic status (SES) is reflecting differences in sociodemographic factors affecting cancer survivorship. Deprived, low SES populations has a higher prevalence of multiple myeloma and worst survival, a gap that widens over time.
Methods: We performed a meta-analysis of 16 studies (registries and cohorts) reporting survival data of myeloma patients according to SES. Ten studies reported Hazzard Ratio (HR) (95 % CI) and 16 studies reported p values. We combined the HR from 10 studies and by using the Mosteller-Bush formula we performed the synthesis of p values according to the area of the globe.
Results: A combination of HR from 10 studies including 85198 myeloma patients weighted to sample size of each study and adopting the hypothesis of random effect returned a combined HR: 1,26 (1,13-1,31) in favor of high SES patients.
USA: Synthesis of p values coming from 6 studies (n=89807 pts) by using the Mosteller and Bush formula extracted a p-value of <0.0001 favoring high SES patients
Oceania: Synthesis of p values in two cohorts from Australia and New Zealand (n= 10196 pts) returned a p-value of 0,022 favoring high SES patients
Europe: The synthesis of p values from UK and Greece studies (n=18533 pts) returned a p-value of <0,0001 favoring high SES patients
Asia: Synthesis of 2 studies from Asia (n=915 pts) returned a p-value of <0,0001 favoring high SES patients
Conclusions: Across the globe and widening over decades socioeconomic status remains a gap for equality in myeloma care
Cardiovascular disease (CVD) emerges as a major cause of death in patients with myelodysplastic syndrome (MDS), but predictors of fatal CVD and the effect of MDS‐specific treatments on CVD mortality remain largely unknown. In an analysis involving 831 patients with MDS with known causes of death, we noted an independent association of lower risk MDS, age >70 years, pre‐existing CVD, and treatment with erythropoiesis‐stimulating agents with a higher risk of death from CVD. If externally validated, these simple risk factors could increase clinicians’ awareness toward CVD complications and guide early introduction of intensive monitoring and preventive interventions in MDS patients.
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