Fiala Mark A, Finney Joseph D, Liu Jingxia, Stockerl-Goldstein Keith E, Tomasson Michael H, Vij Ravi, Wildes Tanya M
a Division of Oncology , Washington University School of Medicine , St. Louis , MO , USA.
b Division of Biostatistics, Department of Medicine , Washington University School of Medicine , St. Louis , MO , USA.
Leuk Lymphoma. 2015;56(9):2643-9. doi: 10.3109/10428194.2015.1011156. Epub 2015 Mar 8.
Population-based studies suggest that black patients with multiple myeloma (MM) have a higher mortality rate than white patients. However, other studies suggest that this disparity is related to socioeconomic status (SES) rather than race. To provide clarity on this topic, we reviewed 562 patients diagnosed with MM at our institution. Patients with high SES had a median overall survival (OS) of 62.8 months (95% confidence interval [CI] 43.1-82.6 months), compared to 53.7 months (45.2-62.3 months) and 48.6 months (40.4-56.8 months) for middle and low SES, respectively (p = 0.015). After controlling for race, age, year of diagnosis, severity of comorbidities, stem cell transplant utilization and insurance provider, patients with low SES had a 54% increase in mortality rate relative to patients with high SES. To support our findings, we performed a similar analysis of 45,505 patients with MM from the Surveillance, Epidemiology and End Results-18 (SEER) database. Low SES is independently associated with poorer OS in MM.
基于人群的研究表明,患有多发性骨髓瘤(MM)的黑人患者的死亡率高于白人患者。然而,其他研究表明,这种差异与社会经济地位(SES)有关,而非种族。为了澄清这一话题,我们回顾了在我们机构被诊断为MM的562名患者。高社会经济地位的患者的中位总生存期(OS)为62.8个月(95%置信区间[CI] 43.1 - 82.6个月),相比之下,中社会经济地位和低社会经济地位的患者分别为53.7个月(45.2 - 62.3个月)和48.6个月(40.4 - 56.8个月)(p = 0.015)。在控制了种族、年龄、诊断年份、合并症严重程度、干细胞移植利用率和保险提供商后,低社会经济地位的患者相对于高社会经济地位的患者死亡率增加了54%。为了支持我们的研究结果,我们对来自监测、流行病学和最终结果-18(SEER)数据库的45505名MM患者进行了类似分析。低社会经济地位与MM患者较差的总生存期独立相关。