Study Observes Racial Disparities in Treatment for Multiple Myeloma

A study published in Blood Advances observed significant differences in the use of novel therapy and autologous hematopoietic cell transplantation (AHCT) among various racial/ethnic groups with multiple myeloma (MM).

Researchers assessed data from the Surveillance Epidemiology and End Results-Medicare database and included 3,504 white (mean age, 75.8 years), 858 black (mean age, 71.8 years), and 468 Hispanic (mean age, 72.7 years) patients with MM.

Differences in treatment, survival, costs, and more

The mean length of time from diagnosis to novel treatment initiation was 2.7 months for white patients, 4.6 months for Hispanic patients, and 5.2 months for black patients (P<0.05).

Researchers assessed rates of patients undergoing AHCT within one year of diagnosis at the following timepoints: 2007 to 2009, 2010 to 2011, and 2012 to 2013. There was an increasing trend in AHCT among white (3.6%, 7.2%, 9.7%; P<0.05) and black (2.5%, 2.2%, 9.3%; P<0.05) patients during these time periods but not Hispanic patients (1.6%, 6.1%, 1.9%).

Median overall survival (OS) was fairly similar: 2.6 years for white patients, 2.5 years for black patients, and 2.8 years for Hispanic patients. Despite this, “both [blacks] and Hispanics may not be fully benefitting from the introduction of novel therapies, as they receive them later than whites,” the authors noted.

Black patients had significantly longer median MM-specific survival (5.4 years) than white patients (4.5 years; P<0.05). Disease-specific survival among whites appeared similar to that of Hispanics (4.9 years).

After adjusting for other factors, the risk for MM-related mortality remained significantly lower for black patients than for white patients (adjusted HR=0.8; P<0.05).

Three-month emergency department visit rate was significantly higher for black (31.2%) versus white (23.8%) patients (adjusted HR=1.2; P<0.01). The mean unadjusted all-cause total monthly healthcare costs were $12,462 for white patients, $13,611 for black patients, and $15,149 for Hispanic patients. Mean unadjusted MM-associated monthly costs were $4,620, $4,384, and $5,568, respectively.