Department of Hematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Hematology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
BMC Cancer. 2020 Aug 8;20(1):737. doi: 10.1186/s12885-020-07178-5.
Disparities in multiple myeloma (MM) prognosis based on sociodemographic factors may exist. We investigated whether education level at diagnosis influenced Chinese MM patient outcomes.
We performed a multicenter retrospective analysis of data from 773 MM patients across 9 centers in China from 2006 to 2019. Sociodemographic and clinical factors at diagnosis and treatment regimens were recorded, and univariate and multivariate analyses were performed.
Overall, 69.2% of patients had low education levels. Patients with low education levels differed from those with high education levels in that they were more likely to be older, and a higher proportion lived in rural areas, were unemployed, had lower annual incomes and lacked insurance. Additionally, compared to patients with high education levels, patients with low education levels had a higher proportion of international staging system (ISS) stage III classification and elevated lactate dehydrogenase (LDH) levels and underwent transplantation less often. Patients with high education levels had a median progression-free survival (PFS) of 67.50 (95% confidence interval (CI): 51.66-83.39) months, which was better than that of patients with low education levels (30.60 months, 95% CI: 27.38-33.82, p < 0.001). Similarly, patients with high education levels had a median overall survival (OS) of 122.27 (95% CI: 117.05-127.49) months, which was also better than that of patients with low education levels (58.83 months, 95% CI: 48.87-62.79, p < 0.001). In the multivariable analysis, patients with high education levels had lower relapse rates and higher survival rates than did those with low education level in terms of PFS and OS (hazard ratio (HR) = 0.50 [95% CI: 0.34-0.72], p < 0.001; HR = 0.32 [0.19-0.56], p < 0.001, respectively).
Low education levels may independently predict poor survival in MM patients in China.
多发性骨髓瘤（MM）的预后可能因社会人口因素而存在差异。我们研究了诊断时的教育水平是否会影响中国 MM 患者的结局。
我们对 2006 年至 2019 年期间来自中国 9 个中心的 773 名 MM 患者的数据进行了多中心回顾性分析。记录了诊断时的社会人口学和临床因素以及治疗方案，并进行了单因素和多因素分析。
总体而言，69.2%的患者受教育程度较低。与受教育程度较高的患者相比，受教育程度较低的患者年龄更大，农村地区居住比例更高，失业比例更高，年收入较低，缺乏保险。此外，与受教育程度较高的患者相比，受教育程度较低的患者国际分期系统（ISS）分期 III 级分类比例较高，乳酸脱氢酶（LDH）水平升高，移植比例较低。受教育程度较高的患者无进展生存期（PFS）的中位数为 67.50（95%置信区间（CI）：51.66-83.39）个月，优于受教育程度较低的患者（30.60 个月，95%CI：27.38-33.82，p<0.001）。同样，受教育程度较高的患者总生存期（OS）的中位数为 122.27（95%CI：117.05-127.49）个月，也优于受教育程度较低的患者（58.83 个月，95%CI：48.87-62.79，p<0.001）。在多变量分析中，与受教育程度较低的患者相比，受教育程度较高的患者 PFS 和 OS 的复发率较低，生存率较高（风险比（HR）=0.50[95%CI：0.34-0.72]，p<0.001；HR=0.32[0.19-0.56]，p<0.001）。
在中国，低教育水平可能独立预测 MM 患者的不良预后。
