Cancer
Evaluating clinical factors implicated in racial differences in survival among patients with multiple myeloma Jade Mason* Malaika Jade Mason Bei Wang Andrew Yang Brian C. Chiu
Unlike the well-recognized two-fold higher incidence rate of multiple myeloma (MM) among African Americans (AA) than European Americans (EA), findings on racial differences in MM survival have been inconclusive. We investigated potential roles of well-recognized prognostic factors in racial disparities in MM overall survival (OS). 561 newly diagnosed MM patients at the University of Chicago Medical Center were prospectively enrolled between 2010-2019 and followed until February 2022. Vital status was ascertained using the National Death Index. OS was defined as time from diagnosis until death from any cause. Baseline sociodemographic and clinical information were collected from electronic medical records and a self-administered questionnaire. We evaluated the associations of race with demographic and prognostic factors using chi-square test for categorical variables and T-test for continuous variables. Of the 561 patients, 151 (27%) were AA and 410 (73%) were EA. Compared with EAs, AAs were significantly older (EAs=61.8 years, AAs=64.0 years, p=0.03), more likely to be obese (EAs vs AA=30.7% vs 43%), and had lower education levels (below college EAs vs AAs=17% vs 22%). AAs had worse age-adjusted OS (HR=1.4; 95% CI=1.0-2.4), compared with EAs. Among the prognostic factors, we found significant racial differences in lactic dehydrogenase (LDH) levels (elevated LDH: 28.5% AAs vs 19.3% EAs, p=0.03) and insurance types (50.2% of EAs had private insurance, 48.3% of AAs had Medicare, p<0.001). There were no racial differences in stage at diagnosis, induction therapy type (i.e., triplets or doublets), and glomerular filtration rate. Multivariate Cox models controlling for confounders and prognostic factors are ongoing and will be presented at the meeting. In the cohort of 561 MM patients, we found significant racial differences in LDH levels and insurance type at time of diagnosis that could potentially explain the racial differences in overall survival amongst MM patients.
