Multiethnic myeloma

Weiss, Brendan M.

doi:10.1182/blood-2013-03-487215

Cited by 8 publications

(6 citation statements)

References 10 publications

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“…Is MM in black individuals a biologically different disease? Early reports suggested a more aggressive presentation in black patients, with a higher incidence of fractures, paraplegia, infections, and overall poor prognosis, all of which were believed to be related to delayed diagnosis . We found that black individuals appeared to fare better than white individuals in terms of survival from the time of diagnosis when equivalent therapy was applied, even if therapy was delayed, as was the case in the patients in the current study with ASCT.…”

Section: Discussionsupporting

confidence: 58%

Disparities in black and white patients with multiple myeloma referred for autologous hematopoietic transplantation: A single center study

Bhatnagar

Goloubeva

et al. 2014

Cancer

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Background: Racial disparity in the incidence of multiple myeloma is well established; however, to the authors' knowledge, little is known regarding the impact of racial differences on disease characteristics, response to therapy, and clinical outcome. Methods: The authors studied 453 patients (174 of whom were black and 279 of whom were white) who underwent transplant between 2000 and 2013. The median follow-up was 4.4 years. Results: Black patients were significantly younger than white patients (median age, 54 years vs 59 years; P<.0001), more frequently presented with anemia (P 5 .04), had more of the immunoglobulin G isotype (P<.001), and had a borderline favorable cytogenetic risk (P 5 .06). Overall response to induction was similar, but deeper responses were observed in more white patients compared with black patients receiving immunomodulatory drug-based induction (P 5 .02). Referral for transplant was significantly delayed in black individuals (median, 1.3 years vs 0.9 years; P 5 .003). Overall survival from the time of transplant was similar for black and white patients, with medians of 6.2 years and 5.7 years, respectively, but survival from the time of diagnosis was significantly longer among black individuals (median, 7.7 years vs 6.1 years; P 5 .03). Maintenance therapy was found to positively impact progression-free survival but not overall survival, irrespective of race. Conclusions: The results of the current study confirm ethnic differences in age, referral patterns, response to therapy, and overall survival. Future validation of these disparities is urgently needed.

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Section: Discussionsupporting

confidence: 58%

Disparities in black and white patients with multiple myeloma referred for autologous hematopoietic transplantation: A single center study

Bhatnagar

Goloubeva

et al. 2014

Cancer

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“…34 Compared to European Americans (EA), MGUS and MM have been observed to occur twice as frequently in African Americans (AAs), with similar transformation rates from MGUS to MM in both races. In addition, older published descriptive studies have suggested same or worse survival outcomes in AAs.…”

Section: Multiple Myeloma Epidemiology: Incidence Survival and Racimentioning

confidence: 99%

“…For example, a prior single-center study found poorer survival among 52 patients with MM at a predominantly AA hospital compared to 92 patients at a predominantly EA hospital. 34 Similarly, a single-institution review of records of 292 patients with MM found that neither race nor socioeconomic status independently were associated with overall survival. 34 Importantly, retrospective data from the South West Oncology Group (SWOG) showed comparable outcomes among AAs and EAs before the advent of ASCT while another small study of ASCT in an equal access health system observed no difference in survival by race.…”

Section: Multiple Myeloma Epidemiology: Incidence Survival and Racimentioning

confidence: 99%

“…34 Similarly, a single-institution review of records of 292 patients with MM found that neither race nor socioeconomic status independently were associated with overall survival. 34 Importantly, retrospective data from the South West Oncology Group (SWOG) showed comparable outcomes among AAs and EAs before the advent of ASCT while another small study of ASCT in an equal access health system observed no difference in survival by race. In order to further understand these differences between AA and EAs in a more systematic and generalized fashion, Landgren and colleagues evaluated the incidence and outcome using the original SEER 9 registries to conduct a large scale population-based study.…”

Section: Multiple Myeloma Epidemiology: Incidence Survival and Racimentioning

confidence: 99%

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Multiple myeloma epidemiology and survival: A unique malignancy

Kazandjian

2016

Seminars in Oncology

587

418

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Multiple myeloma (MM), although a rare disease, is the second most common hematologic malignancy. It is found in the spectrum of plasma cell dyscrasias which begins with monoclonal gammopathy of unknown significance to overt plasma cell leukemia and extramedullary myeloma. MM is associated with significant morbidity due to its end-organ destruction. It is a disease of the older population and its incidence in the African American population is twice that of the European American population. Improvements in the treatment of MM in the past couple of decades, beginning with the use of autologous stem cell transplantation followed by availability of novel treatments such as immunomodulatory drugs and proteasome inhibitors has transformed the natural history of the disease leading to longer survival times. Advancements in the diagnosis, monitoring, and treatment of MM are of the utmost importance as the general population lives longer due to other improvements in health care. The recent introduction of novel therapies has been paralleled by advancements in the monitoring of MM, namely, by the availability exquisitely sensitive techniques in detecting minimal residual disease. As drug development and technology continues to improve, it will be important to design rationale clinical trials enrolling patient populations which represent the overall population including racial minorities and the elderly so trial results can be appropriately extrapolated. This manuscript reviews the changing epidemiology, the improvements in survival, and the health disparity observed in important subgroups of MM.

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“…African Americans were at a proportionately higher risk of death from MM with 7.5 and 5.3/100,000 deaths among African American men and women, respectively, as compared to 3.9 and 2.4 among Caucasians [10]. Retrospective studies from single institutions as well as the South West Oncology Group (SWOG) found no differences in survival based on race [14]. A study that used genetic profiling and fluorescent in situ hybridization (FISH) testing to search for the genetic foundations of the greater risk among African Americans did not find significant results [15].…”

Section: Racementioning

confidence: 99%

Epidemiology, Staging, and Management of Multiple Myeloma

et al. 2021

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Multiple myeloma (MM) is a plasma cell disorder that is on the rise throughout the world, especially in the US, Australia, and Western Europe. In the US, MM accounts for almost 2% of cancer diagnoses and over 2% of cancer deaths (more than double the global proportion). Incidence has risen by 126% globally and over 40% in the US since 1990, while global mortality has risen by 94% and US mortality has fallen by 18%. The 5 year survival in the US has more than doubled over the past decades with the introduction of new targeted therapies and transplant techniques. Risk factors for MM include age (average age of diagnosis is 69), race (African Americans are over double as likely to be diagnosed), sex (men are at a 1.5× risk), and family history. Diagnosis includes serum or urine electrophoresis and free light-chain assay but requires bone marrow biopsy. It is distinguished from smoldering myeloma and monoclonal gammopathy of undetermined significance by a high (>3 g/dL) level of M-protein (monoclonal light chains) and the presence of CRAB (Hypercalcemia, Renal failure, Anemia, Bone pain) symptoms, which include hypercalcemia, renal failure, anemia, and bone pain, suggesting an end-organ damage. International staging system staging involves beta 2 microglobulin and albumin levels, while the revised system considers prognostic factors such as lactate dehydrogenase levels and chromosomal abnormalities. Front-line management includes induction regimen, maintenance therapy and hematopoietic cell transplantation for eligible patients and bisphosphonates or bone-stimulating agents for the prevention of skeletal events. Treatment for relapsed disease includes newly approved monoclonal antibodies like the CD38-targeting daratumumab, proteasome inhibitors, immunomodulating agents, and investigational therapies such as B cell maturation antigen Chimeric antigen receptor T cells.

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Multiethnic myeloma

Cited by 8 publications

References 10 publications

Disparities in black and white patients with multiple myeloma referred for autologous hematopoietic transplantation: A single center study

Disparities in black and white patients with multiple myeloma referred for autologous hematopoietic transplantation: A single center study

Multiple myeloma epidemiology and survival: A unique malignancy

Epidemiology, Staging, and Management of Multiple Myeloma

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