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种族与多发性骨髓瘤的治疗模式和生存结局的关联:Connect MM 注册分析。

Association between race and treatment patterns and survival outcomes in multiple myeloma: A Connect MM Registry analysis.

机构信息

Mayo Clinic, Jacksonville, Florida.

Mount Sinai Hospital, New York, New York.

出版信息

Cancer. 2020 Oct 1;126(19):4332-4340. doi: 10.1002/cncr.33089. Epub 2020 Jul 24.

Abstract

BACKGROUND

Studies have reported racial disparities in access to and use of multiple myeloma (MM) treatments between African American (AA) and White patients. Although AA patients demonstrate longer disease-specific survival, this has not uniformly translated into improved survival over time. The association between race and treatment patterns and survival outcomes was analyzed using data from the Connect MM Registry.

METHODS

The Connect MM Registry is a large US, multicenter, prospective observational cohort study of patients with newly diagnosed MM. Patients who received first-line (1L) stem cell transplantation (SCT) or who did not receive SCT (non-SCT or non-stem cell transplantation [NSCT]) were grouped by raceEffects of race and transplantation status on the use of triplet treatment were estimated using logistic regression.

RESULTS

Treatment patterns in 1L (types and duration of induction, posttransplantation maintenance) were similar between AA and White patients. SCT rates in 1L (32% vs 36%) and triplet treatment use (AA: 44% for NSCT patients and 72% for SCT patients; and White: 48% for NSCT patients and 72% for SCT patients) during first induction were similar. No significant effect of race or transplantation status on 1L triplet treatment use was observed. Race was not found to be associated with survival outcomes among patients who underwent NSCT; however, AA patients who received SCT had significantly longer overall survival compared with White patients who underwent SCT (not reached vs 88.2 months; hazard ratio, 0.56; 95% CI, 0.35-0.89 [P = .0141]).

CONCLUSIONS

AA and White patients were found to have similar treatment patterns in the Connect MM Registry, suggesting that both groups had equal access to health care. In this real-world setting, AA patients received standard-of-care treatment, which might have contributed to better MM-specific survival compared with White patients.

摘要

背景

研究报告称,非裔美国人和白人患者在多发性骨髓瘤(MM)治疗的获得和使用方面存在种族差异。尽管非裔美国人患者的疾病特异性生存率较长,但这并没有在时间推移中转化为生存改善。本研究使用来自 Connect MM 注册研究的数据来分析种族与治疗模式及生存结局之间的关联。

方法

Connect MM 注册研究是一项大型美国、多中心、前瞻性观察队列研究,纳入了新诊断为 MM 的患者。根据种族,将接受一线(1L)干细胞移植(SCT)或未接受 SCT(非 SCT 或非干细胞移植[NSCT])的患者分组。采用 logistic 回归估计种族和移植状态对三联治疗使用的影响。

结果

1L 治疗方案(诱导方案类型和持续时间、移植后维持治疗)在非裔美国人和白人患者之间相似。1L 的 SCT 率(32% vs 36%)和三联治疗使用率(非 SCT 患者的非裔美国人:44%,SCT 患者:72%;SCT 患者:48%,SCT 患者:72%)在第一次诱导时相似。种族或移植状态对 1L 三联治疗使用无显著影响。在接受 NSCT 的患者中,种族与生存结局无关;然而,接受 SCT 的非裔美国患者的总生存明显长于接受 SCT 的白人患者(未达到 vs 88.2 个月;风险比,0.56;95%CI,0.35-0.89[P=0.0141])。

结论

在 Connect MM 注册研究中,非裔美国人和白人患者的治疗模式相似,表明两组均获得平等的医疗保健机会。在这种真实世界环境中,非裔美国患者接受了标准的治疗,这可能有助于其与白人患者相比,多发性骨髓瘤特异性生存情况更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f8d/7540439/1be1619f149a/CNCR-126-4332-g001.jpg

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