Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL.
Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL.
Clin Lymphoma Myeloma Leuk. 2019 Oct;19(10):619-623. doi: 10.1016/j.clml.2019.06.010. Epub 2019 Jun 26.
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.
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.
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.
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.
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。
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。
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。
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。