Outcome Disparities among Ethnic Subgroups of Waldenström's Macroglobulinemia: A Population-Based Study

Abstract

Background: Ethnic disparities in cancers are associated with variability in clinical outcomes. We present a Surveillance Epidemiology and End Results (SEER)-based outcome analysis of multiethnic Waldenström's macroglobulinemia (WM) patients. Methods: Adult WM patients diagnosed in 1992 or later (n = 3,175) were analyzed. Median overall survival (OS) was compared across different ethnicities stratified by year of diagnosis, registry identification, age at diagnosis, sex, and marital status. Results: African-Americans (AA) had the youngest median age at diagnosis (63 years) and Whites had the oldest (73 years) (p < 0.001). Female gender, a younger age at diagnosis, and a recent year of diagnosis were associated with an improved OS. Hispanics had the worst (5.6 years) while Whites had the best (6.8 years) median OS. A significant interaction existed between median OS, gender, and race (p = 0.007). Among males, AA had the worst (4.3 years) and Asians had the best (7.3 years) median OS. A significant interaction was also noted between median OS, age at diagnosis, and race (p = 0.033). The worst median OS was seen in Hispanics among patients aged >75 years, and in AA among those aged <65 years. Conclusions: These disparities among WM patients may be multifactorial but need to be explored systematically to better understand the disease biology and for optimal triaging of health care resources.

Overall survival and competing risks of death in patients with Waldenström macroglobulinaemia: an analysis of theSurveillance,Epidemiology andEndResults database

“…Two recent studies have evaluated outcomes in patients with WM using the SEER database (Sekhar et al , ; Ailawadhi et al , ). Both of these studies analysed a significantly smaller sample than our study, including only patients with WM (ICD‐9 code 9761).…”

Waldenström macroglobulinemia: 2015 update on diagnosis, risk stratification, and management

“…Black patients less commonly have IgM monoclonal gammopathy compared with white patients . Median age at diagnosis is 63 years for blacks and 73 for whites . The presence of the monoclonal IgM protein adds a unique dimension to the disorder because it can result in hyperviscosity syndrome , peripheral neuropathy , hemolytic anemia , and immune complex vasculitis .…”

Evolution of Management and Outcomes in Waldenström Macroglobulinemia: A Population-Based Analysis

“…Subsequent research confirmed a familial predisposition, as well as elevated risk for secondary malignancies in this disease [10,11]. Recent studies suggested better survival [12][13][14] but could not discern whether this was due to earlier diagnosis (lead-time bias) or therapeutic advances. To our knowledge, no reports described use of health services or prevalence of WM-related complications using populationbased data.…”