Racial Disparities Found in Multiple Myeloma Treatment Access

Elderly African American multiple myeloma patients had lower rates of access to autologous stem cell transplant.

Disparities were found among Caucasians and African Americans with newly diagnosed multiple myeloma in treatment access and initiation in a recent study.

The findings were presented at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting and compared treatment patterns, health care costs, and overall survival among the 2 races.

Researchers used the Surveillance, Epidemiology, and End Results Program (SEER) Medicare database to evaluate 2200 Caucasians and 536 African Americans with multiple myeloma from 2007 to 2011.

The index date was defined at the date of diagnosis, and patients were required to be continuously enrolled in Medicare Part A, B, and D for 6 months before and at least 6 months after the index date, unless the patient died.

The results of the study showed that elderly African American multiple myeloma patients had lower rates of access to autologous stem cell transplant (3% vs 6%, respectively) and novel combination therapies (66% vs 74%, respectively, among pharmacological therapy patients) compared with Caucasian multiple myeloma patients.

The median time from diagnosis to therapy initiation was significantly longer for African Americans (2.3 months) than Caucasians (1.7 months), as well as novel therapy initiation (5.3 vs. 3.1 months, respectively).

Overall survival (OS) was found to be comparable among the 2 groups, with African Americans at 26.7 months versus Caucasians at 30 months. Additionally, health care costs were similar across the groups, but African Americans did have higher costs for skilled nursing facilities, emergency room visits, and hospitalizations.

“African Americans may be more at risk for developing multiple myeloma than Caucasians, however, they often can have a better prognosis when they get the proper care,” said study investigator Manali Patel. “Through studies like this, we are trying to better understand potential modifiable drivers of these disparities to improve outcomes for African Americans living with multiple myeloma.”

Authors noted that future studies should examine the differences in disease aggressiveness and other clinical characteristics at baseline among the 2 racial groups.

“Treatment disparities exist between African American and Caucasian patients suffering from multiple myeloma,” said Mohamad Hussein, Vice President of Global Medical Affairs for Celgene. “At Celgene, we believe it is imperative to improve education, awareness and treatment access among African Americans, particularly since they are more predisposed to being diagnosed with the disease.”