Racial Disparities Persist in Treatment of Rare Plasma Cell Disorder

Racial and ethnic minorities comprise only a small percentage of patients seen at specialized treatment centers for light-chain (AL) amyloidosis, despite being at increased risk for this disease.

AL amyloidosis is a condition marked by the production of abnormal proteins from antibodies called light chains, which can then deposit in organs. The disease is commonly associated with multiple myeloma, the most frequent hematologic cancer among Black Americans.

Researchers from the Boston University School of Medicine (BUSM) examined disease characteristics, treatments, and outcomes according to self-reported race/ethnicity of patients with AL amyloidosis referred to the Amyloidosis Center at BUSM between 1990 and 2020. They found that only 14% of the more than 2,400 patients seen during this 30-year period were racial or ethnic minorities, a figure much lower than in the general population.

The investigators observed similarities in disease manifestation across all patient populations but found younger age and more severe illness among racial and ethnic minorities. Fewer minority patients received treatment with stem cell transplantation compared with non-Hispanic white patients. This treatment difference was largely explained by lower educational level and more advanced heart disease among patients of racial or ethnic minorities, according to the researchers.

“These findings indicate that, in order to mitigate disparities, earlier disease detection and efforts to reduce economic and/or language barriers are key. After controlling for disease severity and treatment, race/ethnicity did not independently impact survival,” senior author Vaishali Sanchorawala, MD, professor of medicine and director of the Amyloidosis Center at BUSM and Boston Medical Center, explained in a press release.

These disparities can be mitigated, according to the research team, by increasing healthcare providers’ awareness of manifestations of this disease, such as structural heart changes, nephrosis, and neuropathy, which are symptoms that can mimic common disorders like hypertension and diabetes.

Findings from this study were published in Nature.