International Data on Multiple Myeloma Link Socioeconomic Status to Mortality

Across the globe, socioeconomic status (SES) was shown to be a prognosis factor for overall survival (OS) among patients with multiple myeloma (MM), according to a new study.

Previous studies have established an association between low SES and increased rates of cancer mortality. In this study, researchers from the Democritus University of Thrace in Alexandroupolis, Greece, assessed survival data from patients with MM worldwide to determine any relationship to SES.

“SES is an index calculated based on education, social support, and income but, actually, is a surrogate marker reflecting differences in factors like ethnicity or race, availability of new treatment options, access to health system facilities, disparities in insurance status/refurbishment of anti-myeloma drugs, occupation, and place of living,” explained the researchers in their analysis.

The investigators conducted a meta-analysis of 16 studies. Data on a total of 134,363 million patients with MM diagnosed between 1975 and 2019 were analyzed, with studies from North America, Europe, Australia, and Asia included. P values were synthesized according to geographic location.

Upon stratified P value analysis, higher SES was associated with a lower mortality risk across every study region. The P value for the six U.S. studies, enrolling more than 89,000 patients, was <0.0001 in favor of higher SES. The P value for two studies of more than 101,000 patients from Australia and New Zealand was 0.022 and <0.0001 for the European cohort of more than 185,000 patients. Two studies from Asia were included, enrolling a total of 915 patients, for which the P value was <0.0001. Overall, higher SES was consistently associated with better survival.

Ten studies, with 85,198 total patients, reported hazard ratios (HRs) for five-year MM mortality, which were combined using the Mosteller-Bush formula. Patients with higher SES had a 1.26 HR, or odds of survival, at five years (95% confidence interval, 1.13-1.31).

“We demonstrated that SES remains a significant prognostic factor for OS in [patients with] myeloma globally,” the researchers concluded. “Financial intoxication of myeloma care on health systems and patients is rising through the decades. Therefore, the gap in myeloma care between deprived and affluent patients is expected to widen in the future.”

These findings were published in the Mediterranean Journal of Hematology and Infectious Diseases.