Nieto Maria Jacqueline, Hedjar Aryles, Locke Margaret, Caro Jessica, Saif Muhammad Wasif
Department of Cancer, Northwell Health Cancer Institute & Donald and Barbara Zucker School of Medicine at Hofstra, Lake Success, NY, USA.
Orlando Health Cancer Institute, Orlando, FL, USA.
J Clin Haematol. 2023;4(1):35-42. doi: 10.33696/haematology.4.055.
During the past two decades, new therapeutic agents have greatly improved the treatment landscape in multiple myeloma (MM). Treatments such as proteasome inhibitors, immunomodulatory agents, targeted monoclonal antibody therapy, and chimeric antigen receptor (CAR) T-cell therapy have improved outcomes with less toxicity. Advances in laboratory testing have accompanied this change, performing faster and more accurate assessments of treatment response. Despite these advances, however, disparities in MM outcomes persist.
The purpose of this study was to review epidemiological trends in MM over the past two decades and to identify disparities that may impact MM identification and survival.
Retrospective analysis was conducted on adult patients diagnosed with MM between the years 2000-2019 using the November 2021 Surveillance, Epidemiology, and End Results (SEER) program database. Joinpoint models were used to calculate annual percent changes (APCs) and average annual percent change (AAPC).
There were a total of 111,328 diagnoses of MM extracted from the SEER database. Most patients were male (55.17%) and white (76.7%). Age-adjusted rate analysis found a significantly higher incidence among black patients compared to white patients. The APC between 2000-2015 was 1.46, and the APC between 2015-2019 was -1.34. Relative survival also increased from 2000 to 2014. The 5-year cancer survival in MM also increased at an average of 1.8% for every year after diagnosis. The annual probability of MM-related mortality at the 1-year mark also decreased from 28.5% in 2000 to 16.7% in 2018.
Novel advances in MM therapeutic agents and diagnostic testing have paved the way for significant improvements in patient survival outcomes. Disparities persist along racial lines. Further research is needed to evaluate responses to specific MM treatment in the age of newly developed targeted therapies to overcome these disparities.
在过去二十年中，新型治疗药物极大地改善了多发性骨髓瘤（MM）的治疗前景。蛋白酶体抑制剂、免疫调节剂、靶向单克隆抗体疗法和嵌合抗原受体（CAR）T细胞疗法等治疗方法提高了疗效且毒性更小。实验室检测的进步伴随着这一变化，能够更快、更准确地评估治疗反应。然而，尽管有这些进展，MM治疗结果的差异仍然存在。
本研究的目的是回顾过去二十年中MM的流行病学趋势，并确定可能影响MM识别和生存的差异。
使用2021年11月的监测、流行病学和最终结果（SEER）计划数据库，对2000年至2019年间诊断为MM的成年患者进行回顾性分析。连接点模型用于计算年度百分比变化（APC）和平均年度百分比变化（AAPC）。
从SEER数据库中总共提取了111328例MM诊断病例。大多数患者为男性（55.17%）和白人（76.7%）。年龄调整率分析发现，黑人患者的发病率显著高于白人患者。2000 - 2015年期间的APC为1.46，2015 - 2019年期间的APC为 -1.34。相对生存率从2000年到2014年也有所提高。MM的5年癌症生存率在诊断后每年平均也增加1.8%。MM相关死亡率在1年时的年度概率也从2000年的28.5%降至2018年的16.7%。
MM治疗药物和诊断检测的新进展为患者生存结果的显著改善铺平了道路。种族差异仍然存在。需要进一步研究来评估在新开发的靶向治疗时代对特定MM治疗的反应，以克服这些差异。
