Health Disparities Among Hospitalized Black Patients with Myeloma

Black patients with multiple myeloma (MM) experience significant health disparities, according to a study.

“MM is the most common hematologic malignancy in Black Americans. Incidence and death rates for MM in Black Americans are more than double those in Whites,” the researchers noted.

Using the National Inpatient Sample, they retrospectively reviewed data on hospitalizations in adult patients with MM between 2008 and 2017. Joinpoint regression was implemented to evaluate temporal trends in in-hospital death rates, and the investigators calculated adjusted odds ratios for the incidence of in-hospital death.

Overall, 913,967 out of 285,876,821 hospitalizations during the study period were related to MM. MM-related hospitalizations were more prevalent among Black patients than white patients (476 vs. 305.6 per 100,000 hospitalizations, P<0.01). Older patients, males, patients in the lowest zip code quartile, and those who self-paid for their treatment had higher in-hospital mortality.

In-hospital mortality among patients with MM significantly declined, per the Average Annual Percent Change, for all patients except Black patients. The authors noted that inpatient mortality was highest for Black patients in 2016 and 2017. Regarding treatment, Black patients had lower rates of autologous cell transplantation (2.8% vs. 3.8%), palliative care consultation (4% vs. 4.6%), and chemotherapy (10.8% vs. 11.2%), and higher rates of blood product transfusions (23% vs. 21.1%) and intensive care utilization (5.3% vs. 4.3%), compared to white patients.

“Data suggest higher disease burden, more frequent hospitalizations, delay in accessing care and lower utilization of supportive care measures compared with White MM patients. Data highlight disparities in MM care for Black Americans necessitating a clarion call for urgent changes in health care systems,” the researchers wrote in their conclusion.

The results of the study were published in the Journal of Clinical Oncology.