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年轻多发性骨髓瘤患者的生存趋势:关注少数族裔。

Survival Trends in Young Patients With Multiple Myeloma: A Focus on Racial-Ethnic Minorities.

机构信息

Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL.

Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL.

出版信息

Clin Lymphoma Myeloma Leuk. 2019 Oct;19(10):619-623. doi: 10.1016/j.clml.2019.06.010. Epub 2019 Jun 26.

DOI:10.1016/j.clml.2019.06.010
PMID:31377212
Abstract

INTRODUCTION

Outcomes in multiple myeloma (MM) have improved significantly over time. This is true overall for all patients as well as patient subgroups based on age and race/ethnicity. Despite this, disparities are noted in outcomes when looking at racial subgroups.

MATERIALS AND METHODS

We performed an analysis from the population-based Surveillance, Epidemiology, and End Results (SEER) database to evaluate improvement in relative survival rates (RSRs) for young (≤ 40 years at the time of MM diagnosis) and older (> 40 years at the time of MM diagnosis) over time by race/ethnicity, specifically focusing on Hispanic patients with MM. Expected survival was estimated using the age- and gender-specific death rates from the United States population. RSR was provided as the ratio of the observed to expected survival at individual time points. Five-year and 10-year RSRs were calculated for patients based on treatments modalities available in various time periods.

RESULTS

We identified a total of 89,451 patients with MM in SEER, of which 1460 patients formed the young patients with MM (≤ 40 years) cohort. Five- and 10-year RSR improved significantly over time for all patients and older patients (> 40 years) by race (all P < .001). Evaluating the younger patients, RSR improved significantly for non-Hispanic whites and non-Hispanic blacks, but not for Hispanics. This was true for the 5-year (P = .08) and 10-year (P = .13) RSRs.

CONCLUSION

We report a lack of significant benefit in long-term outcomes for younger Hispanic patients with MM over time. This could be owing to multifactorial causes that need to be addressed to mitigate outcome disparities.

摘要

简介

多发性骨髓瘤(MM)的治疗结果随着时间的推移有了显著改善。对于所有患者以及基于年龄和种族/民族的患者亚组而言,这一点都是真实的。尽管如此,在观察种族亚组时,仍会注意到结果存在差异。

材料与方法

我们从基于人群的监测、流行病学和最终结果(SEER)数据库中进行了分析,以评估不同种族/民族的年轻(MM 诊断时≤ 40 岁)和老年(MM 诊断时> 40 岁)患者的相对生存率(RSR)随时间的变化,特别关注患有 MM 的西班牙裔患者。预期生存使用美国人口的年龄和性别特异性死亡率进行估计。RSR 作为个体时间点观察到的与预期生存的比值提供。根据不同时期可用的治疗方式,为患者计算了 5 年和 10 年 RSR。

结果

我们在 SEER 中总共确定了 89451 例 MM 患者,其中 1460 例患者形成了年轻 MM(≤ 40 岁)患者队列。所有患者和老年患者(> 40 岁)的 RSR 随时间显著提高(所有 P<0.001)。对于年轻患者,非西班牙裔白人和非西班牙裔黑人的 RSR 显著提高,但西班牙裔患者并非如此。5 年(P=0.08)和 10 年(P=0.13)RSR 均如此。

结论

我们报告称,随着时间的推移,年轻西班牙裔 MM 患者的长期结果没有显著改善。这可能是由于需要解决的多因素原因,以减轻结果差异。

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