Evaluating Race and Time to Transplantation in Multiple Myeloma: The Mount Sinai Hospital Experience

Clin Lymphoma Myeloma Leuk. 2021 Feb 16:S2152-2650(21)00064-1. doi: 10.1016/j.clml.2021.02.003. Online ahead of print.


BACKGROUND: Previous studies have found that Black patients with multiple myeloma undergo autologous stem-cell transplantation (ASCT) less frequently than their white counterparts, although the factors leading to decreased access and utilization have not been fully elucidated.

PATIENTS AND METHODS: To identify whether racial differences in transplantation timing played a role in these disparities, we retrospectively analyzed 410 Black and white patients who received their first transplant at The Mount Sinai Hospital between 2011 and 2016 (260 white and 150 Black patients). We compared the time from initial diagnosis to stem-cell collection and the time from collection to transplantation between the 2 races while controlling for age, socioeconomic status, and functional status.

RESULTS: Between Blacks and whites, time from diagnosis to collection was higher in Black patients (median 238, vs. 195 days, respectively, P = .051). Functional status, socioeconomic status, and age were also significantly associated with time to collection, and after controlling for these covariates, the effect of race was not significant (P = .0625). Conversely, time from collection to transplantation was increased in white patients compared to Black.

CONCLUSION: Increased time from diagnosis to stem-cell collection for Black patients was driven in part by socioeconomic status and baseline functional status.

PMID:33757769 | DOI:10.1016/j.clml.2021.02.003