Lack of differential impact of del17p on survival in African Americans compared with White patients with multiple myeloma: a VA study

Abstract

Multiple myeloma (MM) is a heterogeneous disease featured by an increased incidence in African Americans (AA). We have previously observed that with equal access to healthcare, younger AA (age <65 years) patients have superior overall survival (OS) than white patients. As MM prognosis is influenced by presence of del17p, we investigated racial differences in its occurrence and impact in a large cohort of MM patients from the Veterans Affairs (VA) system. Among 2243 VA patients with MM for whom del17p data was available, del17p was present in 8.83% of all patients, with significantly lower prevalence in AA (5.56%) compared to white (10.52%, p<0.001). The difference was even more pronounced among younger (<65 years) AA (4.34%) versus white (9.8%, p=0.004). However, we observed no significant difference in survival between AA and white patients with del17p regardless of age category, suggesting that del17p carries a poor prognosis across race and age. Interestingly, among patients without del17p, we still noted a significantly superior OS in younger AA as compared to white (7.75 vs. 5.10 years, p=0.042). Our study shows a lower incidence of del17p in AA but suggests that the survival advantage for younger AA is primarily due to factors other than del17p.

Racial differences in treatment and survival among older patients with multiple myeloma

“…Collectively, these findings indicated that biological differences in MM may exist by race. For example, analyzing VA data, researchers discovered NHAA patients had a lower prevalence of the Del17p mutation, a genetic abnormality linked to poor prognosis, compared to NHW patients 18 . Some studies even found that when taking treatments into consideration, NHAA patients had better survival than NHW patients 19–21 .…”

“…For example, analyzing VA data, researchers discovered NHAA patients had a lower prevalence of the Del17p mutation, a genetic abnormality linked to poor prognosis, compared to NHW patients. 18 Some studies even found that when taking treatments into consideration, NHAA patients had better survival than NHW patients. [19][20][21] Fillmore et al reported that in the veteran population, who had relatively equal access to care compared to the general population, NHAA patients aged <65 years had better survival than their NHW counterparts.…”

Racial Differences in Spinal Cord Compression Related Hospitalizations in Patients with Multiple Myeloma

“…Non-Hispanic (NH) Black and Hispanic persons with multiple myeloma (MM) face multiple health-related disparities that include lower access to novel therapies and under-utilization of autologous stem cell transplantation [ 1 , 2 ]. Differences in biology may be associated with different clinical presentations and/or outcomes [ 3 , 4 ]. MM is more common in NH Black persons.…”

Racial Differences in Spinal Cord Compression Related Hospitalizations in Patients with Multiple Myeloma

“…

Non-Hispanic (NH) Black and Hispanic persons with multiple myeloma (MM) face multiple health-related disparities that include lower access to novel therapies and under-utilization of autologous stem cell transplantation [1,2]. Differences in biology may be associated with different clinical presentations and/or outcomes [3,4]. MM is more common in NH Black persons.

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