Characteristics of long-term survivors with multiple myeloma: A National Cancer Data Base analysis

Ronan W. Hsieh, Ronald S. Go, Jithma P. Abeykoon, Prashant Kapoor, Shaji K Kumar, Morie Gertz, Francis K. Buadi, Nelson Leung, Wilson Gonsalves, Taxiarchis Kourelis, Rahma M. Warsame, Angela Dispenzieri, Martha Lacy, Robert A. Kyle, S Vincent Rajkumar, Jonas Paludo

Research output: Contribution to journalArticle

Abstract

Background: There exist insufficient data characterizing patients with multiple myeloma (MM) who experienced prolonged survival. A population-based analysis of long-term survivors was conducted to investigate the roles of sociodemographic factors and upfront stem cell transplantation (SCT). Methods: The National Cancer Data Base is a US cancer database of approximately 34 million patients from >1500 cancer centers. Patients with MM were identified using the International Classification of Diseases for Oncology (ICD-O) code 9732 from January 2004 to December 2006 and were divided into 4 groups based on overall survival (OS). Sociodemographic characteristics, treatment facility, and use of SCT were recorded. The univariate and multivariate analyses were performed using multiple logistic regression and Pearson chi-square tests. Results: A total of 26,986 patients with MM were identified. The median OS was 2.74 years. The majority of patients were male (54%), white (77%), insured (93%) and otherwise healthy (78%), lived in a metropolitan area (82%), were of high income (66%) and educational (58%) levels, and received treatment at nonacademic facilities (63%). Upfront SCT was used in 10% of patients. One in 6 patients (16%) were long-term survivors (group 4). When comparing group 4 (OS of ≥8.22 years) with the other groups (OS of <8.22 years), young age, female sex, high income and educational levels, residence in a rural area, insured status, no comorbidity, receipt of upfront SCT, and treatment at high-volume facilities were associated with long-term survival. Conclusions: Key differences in sociodemographic characteristics, patient volume at treatment facilities, and upfront SCT were associated with long-term survival. Improvements in health care access and health literacy, upfront SCT, and treatment at high-volume facilities might prolong patient survival.

Original languageEnglish (US)
JournalCancer
DOIs
StatePublished - Jan 1 2019

Keywords

  • hematologic malignancy
  • multiple myeloma
  • National Cancer Data Base
  • plasma cell dyscrasia
  • stem cell transplantation

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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