Health care and outcome disparities are of key concern as providers seek to improve the health of all patients regardless of demographics. Megan H. Jagosky, MD, Department of Internal Medicine, Carolinas Medical Center/Carolinas HealthCare System in Charlotte, NC, discussed the outcomes of transplant eligible multiple myeloma (MM) African American patients compared to Caucasian patients at the 58th American Society of Hematology Annual Meeting and Exposition in San Diego, CA.
The authors looked at data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute between 1975 and 2008 and found significant disparities in the incidence of MM in African Americans compared to Caucasians—two to three times higher in African Americans.
“Differences in the incidence appear to be genetically driven, but remain poorly understood. Although African American patients appear to have a lower incidence of high risk cytogenetics,” said Jagosky, citing Greenberg et al. “Their outcomes have not improved in the novel era therapy compared to Caucasian patients.”
Study authors posited that African American patients with MM may struggle to access specialized disease-specific care, such as care at transplant centers, because of socioeconomic status and limited social support.
Jagosky and colleagues sought to prospectively examined the transplant outcomes of African American and Caucasian patients with MM at the Department of Internal Medicine at Carolinas Medical Center/Carolinas HealthCare System. Researchers examined the MM database from March to December 2015, for all autologous stem cell transplant- (ASCT-) eligible patients with MM, resulting in 73 participants. Clinical features, induction regimens, treatment responses, and ASCT outcomes were compared between African American and Caucasian patients.
Of the 73 patients, sex was not a significant factor between the two groups, but the African American patients were much younger at the time of diagnosis—56 years versus 61 years in the Caucasian cohort. What’s more, no statistically noteworthy variances occurred in any other clinical variable at diagnosis except for lower hemoglobin levels among African American patients. Both groups also had similar response rates to induction therapy and little difference in one-year progression-free survival.
“Although longer follow-up is required, our data suggest that when African American patients with MM are provided similar access to care as Caucasian patients with MM, similar response rates to induction therapy and ASCT can be achieved,” said Jagosky.