Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
Biol Blood Marrow Transplant. 2010 Mar;16(3):395-402. doi: 10.1016/j.bbmt.2009.11.007. Epub 2009 Nov 14.
Blacks are twice as likely to develop and die from multiple myeloma (MM), and are less likely to receive an autologous hematopoietic-cell transplant (AHCT) for MM compared to Whites. The influence of race on outcomes of AHCT for MM is not well described. We compared the probability of overall survival (OS), progression-free survival (PFS), disease progression, and nonrelapse mortality (NRM) among Black (N=303) and White (N=1892) recipients of AHCT for MM, who were reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) from 1995 to 2005. The Black cohort was more likely to be female, and had better Karnofsky performance scores, but lower hemoglobin and albumin levels at diagnosis. Black recipients were younger and more likely to be transplanted later in their disease course. Disease stage and treatment characteristics prior to AHCT were similar between the 2 groups. Black and White recipients had similar probabilities of 5-year OS (52% versus 47%, P=.19) and PFS (19% versus 21%, P=.64) as well as cumulative incidences of disease progression (72% versus 72%, P=.97) and NRM (9% versus 8%, P=.52). In multivariate analyses, race was not associated with any of these endpoints. Black recipients of AHCT for MM have similar outcomes compared to Whites, suggesting that the reasons underlying lower rates of AHCT in Blacks need to be studied further to ensure equal access to effective therapy.
黑人患多发性骨髓瘤（MM）并因此死亡的几率是白人的两倍，与白人相比，他们接受自体造血细胞移植（AHCT）治疗 MM 的几率也更低。种族对 MM 患者 AHCT 治疗结果的影响尚未得到充分描述。我们比较了报告给国际血液和骨髓移植研究中心（CIBMTR）的 1995 年至 2005 年间接受 MM 的 AHCT 治疗的黑人（N=303）和白人（N=1892）患者的总生存率（OS）、无进展生存率（PFS）、疾病进展率和非复发死亡率（NRM）。黑人队列中女性更多，Karnofsky 表现评分更好，但诊断时的血红蛋白和白蛋白水平较低。黑人患者年龄更小，且更有可能在疾病晚期接受移植。两组患者在 AHCT 前的疾病分期和治疗特征相似。黑人患者和白人患者 5 年 OS （52% vs. 47%，P=.19）和 PFS（19% vs. 21%，P=.64）以及疾病进展的累积发生率（72% vs. 72%，P=.97）和 NRM（9% vs. 8%，P=.52）的概率相似。多变量分析显示，种族与这些终点均无相关性。接受 MM 的 AHCT 治疗的黑人患者与白人患者的结局相似，这表明需要进一步研究导致黑人 AHCT 率较低的原因，以确保其获得有效治疗的机会均等。
