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西班牙语裔人群中的多发性骨髓瘤:发病情况、特征、生存情况、应用真实世界和 Connect MM 登记数据的发现结果和验证。

Multiple Myeloma in Hispanics: Incidence, Characteristics, Survival, Results of Discovery, and Validation Using Real-World and Connect MM Registry Data.

机构信息

Department of Medical Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY; John Theurer Cancer Center, Hackensack, NJ.

Department of Internal Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, NY.

出版信息

Clin Lymphoma Myeloma Leuk. 2021 Apr;21(4):e384-e397. doi: 10.1016/j.clml.2020.11.013. Epub 2020 Nov 21.

Abstract

BACKGROUND

Multiple myeloma (MM) in Hispanics has never been studied. We therefore sought to determine the clinical characteristics and overall survival in MM of Hispanics compared to non-Hispanic whites (NHW) and non-Hispanic blacks (NHB).

PATIENTS AND METHODS

A single-center analysis of 939 patients diagnosed with MM from 2000 to 2017 with a large representation of NHB (n = 489), Hispanics (n = 281), and NHW (n = 169) was conducted to evaluate outcomes and disease characteristics. We used the Connect MM Registry, a large US multicenter prospective observational study with newly diagnosed MM patients, as a validation cohort.

RESULTS

Hispanics had a higher incidence of MM compared to NHW. The median age at presentation was 5 years younger (median, 65 years) in Hispanics compared to NHW (median, 70 years), and patients were more likely to present with renal dysfunction (estimated glomerular filtration rate < 30 mL/min). Hispanics had a higher proportion of Revised International Staging System (R-ISS) stage I disease compared to NHW and NHB (P = .03), while there was no difference in cytogenetics between Hispanics and NHB/NHW. In the multivariate analysis, only high-risk disease and response to first-line therapy significantly affected survival.

CONCLUSION

In this first and largest analysis of MM in Hispanics, we found that Hispanics present at a younger age, have a higher incidence of renal dysfunction, and have low R-ISS stage disease at presentation. With equal access to therapy, Hispanics have survival similar to NHW/NHB.

摘要

背景

西班牙裔人群中的多发性骨髓瘤(MM)从未被研究过。因此,我们旨在比较西班牙裔与非西班牙裔白人(NHW)和非西班牙裔黑人(NHB)的 MM 患者的临床特征和总生存期。

患者和方法

对 2000 年至 2017 年间在单一中心确诊为 MM 的 939 例患者进行了分析,其中包括大量 NHB(n=489)、西班牙裔(n=281)和 NHW(n=169)患者,以评估其结局和疾病特征。我们使用了 Connect MM Registry,这是一项大型美国多中心前瞻性观察性研究,包含新诊断的 MM 患者,作为验证队列。

结果

与 NHW 相比,西班牙裔的 MM 发病率更高。西班牙裔患者的中位发病年龄比 NHW 年轻 5 岁(中位年龄 65 岁),且更易发生肾功能不全(估算肾小球滤过率<30 mL/min)。与 NHW 和 NHB 相比,西班牙裔患者具有更高比例的修订国际分期系统(R-ISS)I 期疾病(P=0.03),但西班牙裔和 NHB/NHW 之间的细胞遗传学并无差异。在多变量分析中,只有高危疾病和一线治疗反应显著影响生存。

结论

在这项针对西班牙裔 MM 的首次且最大规模分析中,我们发现西班牙裔患者发病年龄更小,肾功能不全的发生率更高,且初诊时的 R-ISS 分期较低。在获得同等治疗机会的情况下,西班牙裔患者的生存情况与 NHW/NHB 相似。

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