Division of Hematology, University of Southern California, Los Angeles, CA, USA.
Br J Haematol. 2012 Jul;158(1):91-8. doi: 10.1111/j.1365-2141.2012.09124.x. Epub 2012 Apr 26.
Studies of ethnic disparities in malignancies have revealed variation in clinical outcomes. In multiple myeloma (MM), previous literature has focused only on patients of Caucasian and African-American (AA) descent. We present a Surveillance Epidemiology and End Results (SEER)-based outcome analysis of MM patients from a broader range of ethnicities, representing current United States demographics. The SEER 17 Registry data was utilized to analyse adult MM patients diagnosed since 1992 (n = 37,963), as patients of other ethnicities were not well represented prior to that. Overall survival (OS) and myeloma-specific survival (MSS) were compared across different ethnicities stratified by year of diagnosis, registry identification, age, sex and marital-status. Hispanics had the youngest median age at diagnosis (65 years) and Whites had the oldest (71 years) (P < 0·001). Increased age at diagnosis was an independent predictor of decreased OS and MSS. Asians had the best median OS (2·7 years) and MSS (4·1 years), while Hispanics had the worst median OS (2·4 years). These trends were more pronounced in patients ≥ 75 years. Cumulative survival benefit over successive years was largest among Whites (1·3 years) and smallest among Asians (0·5 years). These disparities may be secondary to multifactorial causes that need to be explored and should be considered for optimal triaging of healthcare resources.
对恶性肿瘤的种族差异研究揭示了临床结局的变化。在多发性骨髓瘤 (MM) 中,以前的文献仅关注白种人和非裔美国人 (AA) 患者。我们展示了一项基于监测、流行病学和最终结果 (SEER) 的 MM 患者结局分析,这些患者来自更广泛的种族,代表了当前美国的人口统计学特征。利用 SEER 17 登记处的数据,分析了自 1992 年以来诊断的成年 MM 患者 (n = 37963),因为在此之前,其他种族的患者代表性不足。根据诊断年份、登记处标识、年龄、性别和婚姻状况对不同种族的患者进行分层,比较总体生存率 (OS) 和骨髓瘤特异性生存率 (MSS)。西班牙裔患者的诊断中位年龄最小 (65 岁),白种人最大 (71 岁) (P < 0·001)。诊断时年龄的增加是 OS 和 MSS 降低的独立预测因素。亚洲人的中位 OS (2·7 年) 和 MSS (4·1 年) 最好,而西班牙裔的中位 OS (2·4 年) 最差。这些趋势在年龄≥75 岁的患者中更为明显。在连续数年中,白人的累积生存获益最大 (1·3 年),亚洲人最小 (0·5 年)。这些差异可能是多因素造成的,需要进一步探讨,并应考虑为优化医疗资源的分诊提供依据。