Findings of Multiple Myeloma in Afro-Caribbean Patients in the United States

Abstract

BackgroundMultiple myeloma (MM) is the second most common malignancy in the United States and has a higher incidence in the black and Afro-Caribbean population. There remain limited data on disease presentation and clinical characteristics in this patient group in the United States. The clinical profile of MM in this underrepresented patient group is described here.MethodsThis retrospective study was conducted at Kings County Hospital, an urban New York City hospital in a majority Afro-Caribbean neighborhood. Data from patients diagnosed with MM from 2000 through 2013 were collected from the institution’s tumor registry. Clinical and demographic characteristics of these patients were then analyzed.ResultsPatients with a diagnosis of MM were identified (N = 287). Data were available for 231 patients and of these, 97% self-identified as black. 55% were female, and there was a male-to-female ratio of 1:1.2. The mean age of female patients was 64 years; that of male patients was 63 years. Of the 231 patients, 81% had anemia, 68% had bone lesions, 47% had renal impairment, and 29% had hypercalcemia. Low levels of monoclonal protein were present in 27% of patients and 57% had disease of International Staging System stages I and II. Women had higher BMI than men.ConclusionThe mean age of presentation of MM in Afro-Caribbean patients is similar to that in the standard population; however, unlike the general US population, there was a higher incidence in women; mean BMI of women also was higher than that of male patients. A sizeable percentage of Afro-Caribbean patients with MM presented with low levels of monoclonal protein in the presence of multiorgan involvement and damage, suggesting the need for early and aggressive diagnostic testing.

Characteristics and outcomes of patients with multiple myeloma at the Uganda Cancer Institute

“…Our data is consistent with the observation that MM is more prevalent in males 26 ; however, compared with the global statistics which reports the mean age at diagnosis of MM as 66 27 – 29 , our data depicts a younger mean(SD) age at diagnosis of 59 (12.8) years. In a series of 123 patients (49 black and 74 white) observed over 1971 to 1976 in Johannesburg, South Africa, 30 the median age of clinical presentation in the black patients was 52 years, 10 years younger than the median age for the white patients.…”

“…Our data is consistent with the observation that MM is more prevalent in males 26 ; however, compared with the global statistics which reports the mean age at diagnosis of MM as 66 [27][28][29] The median survival of patients with MM is approximately 5 -7 years with survival varying depending on host factors, tumor burden (stage), biology (cytogenetic abnormalities), and response to therapy [37][38][39] . In contrast, the median survival of patients in our study of only 2.5 years, was much shorter than observed elsewhere.…”

Hematological malignancies in East Africa—Which cancers to expect and how to provide services

“…Similar figures have been documented in retrospective studies conducted in both Nigeria and Cameroon where median ages of 62 and 57 years have been quoted [8,9]. Interestingly however, in American cohorts although disease seems to be more aggressive in black patients, with shorter overall survival, no racial disparity was noted in age of onset [10,11].…”