Pan Darren, Coltoff Alexander, Ozbek Umut, Lin Jung-Yi, Afshar Solmaz, Galitzeck Zachary, Steinberg Amir
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
Division of Hematology Oncology, Columbia University Irving Medical Center, New York, NY.
Clin Lymphoma Myeloma Leuk. 2021 Jul;21(7):439-443. doi: 10.1016/j.clml.2021.02.003. Epub 2021 Feb 16.
Previous studies have found that Black patients with multiple myeloma undergo autologous stem-cell transplantation (ASCT) less frequently than their white counterparts, although the factors leading to decreased access and utilization have not been fully elucidated.
To identify whether racial differences in transplantation timing played a role in these disparities, we retrospectively analyzed 410 Black and white patients who received their first transplant at The Mount Sinai Hospital between 2011 and 2016 (260 white and 150 Black patients). We compared the time from initial diagnosis to stem-cell collection and the time from collection to transplantation between the 2 races while controlling for age, socioeconomic status, and functional status.
Between Blacks and whites, time from diagnosis to collection was higher in Black patients (median 238, vs. 195 days, respectively, P = .051). Functional status, socioeconomic status, and age were also significantly associated with time to collection, and after controlling for these covariates, the effect of race was not significant (P = .0625). Conversely, time from collection to transplantation was increased in white patients compared to Black.
Increased time from diagnosis to stem-cell collection for Black patients was driven in part by socioeconomic status and baseline functional status.
先前的研究发现，患有多发性骨髓瘤的黑人患者接受自体干细胞移植（ASCT）的频率低于白人患者，尽管导致获取和利用率降低的因素尚未完全阐明。
为了确定移植时机的种族差异是否在这些差异中起作用，我们回顾性分析了2011年至2016年间在西奈山医院接受首次移植的410名黑人和白人患者（260名白人患者和150名黑人患者）。我们比较了两个种族从初始诊断到干细胞采集的时间以及从采集到移植的时间，同时控制年龄、社会经济地位和功能状态。
在黑人和白人之间，黑人患者从诊断到采集的时间更长（中位数分别为238天和195天，P = 0.051）。功能状态、社会经济地位和年龄也与采集时间显著相关，在控制这些协变量后，种族的影响不显著（P = 0.0625）。相反，与黑人相比，白人患者从采集到移植的时间增加。
黑人患者从诊断到干细胞采集时间的增加部分是由社会经济地位和基线功能状态驱动的。
