TY - JOUR
T1 - Examining allostatic load, neighborhood socioeconomic status, symptom burden and mortality in multiple myeloma patients
AU - Obeng-Gyasi, Samilia
AU - Graham, Noah
AU - Kumar, Shaji
AU - Lee, Ju Whei
AU - Jacobus, Susanna
AU - Weiss, Matthias
AU - Cella, David
AU - Zhao, Fengmin
AU - Ip, Edward H.
AU - O’Connell, Nathaniel
AU - Hong, Fangxin
AU - Peipert, Devin J.
AU - Gareen, IIana I.F.
AU - Timsina, Lava R.
AU - Gray, Robert
AU - Wagner, Lynne I.
AU - Carlos, Ruth C.
N1 - Funding Information:
This study was supported by the National Cancer Institute of the National Institutes of Health under the following award numbers: U01CA233169, U10CA180820, U10CA180794, UG1CA189828, UG1CA232760, UG1CA233320, UG1CA233160, and UG1CA233331. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This funding source had no role in the design of this study and will not have any role during its execution, analyses, interpretation of the data, or decision to submit results.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/4
Y1 - 2022/4
N2 - The objective of this study is to examine the association between neighborhood socioeconomic status (nSES) and baseline allostatic load (AL) and clinical trial endpoints in patients enrolled in the E1A11 therapeutic trial in multiple myeloma (MM). Study endpoints were symptom burden (pain, fatigue, and bother) at baseline and 5.5 months, non-completion of induction therapy, overall survival (OS) and progression-free survival (PFS). Multivariable logistic and Cox regression examined associations between nSES, AL and patient outcomes. A 1-unit increase in baseline AL was associated with greater odds of high fatigue at baseline (adjusted OR [95% CI] = 1.21 [1.08–1.36]) and a worse OS (adjusted hazard ratio, [95% CI] = 1.21 [1.06–1.37]). High nSES was associated with worse baseline bother (middle OR = 4.22 [1.11–16.09] and high 4.49 [1.16–17.43]) compared to low nSES. There was no association between AL or nSES and symptom burden at 5.5 months, non-completion of induction therapy or PFS. Additionally, there was no association between nSES and OS. AL may have utility as a predictive marker for OS among patients with MM and may allow individualization of treatment. Future studies should standardize and validate AL patients with MM.
AB - The objective of this study is to examine the association between neighborhood socioeconomic status (nSES) and baseline allostatic load (AL) and clinical trial endpoints in patients enrolled in the E1A11 therapeutic trial in multiple myeloma (MM). Study endpoints were symptom burden (pain, fatigue, and bother) at baseline and 5.5 months, non-completion of induction therapy, overall survival (OS) and progression-free survival (PFS). Multivariable logistic and Cox regression examined associations between nSES, AL and patient outcomes. A 1-unit increase in baseline AL was associated with greater odds of high fatigue at baseline (adjusted OR [95% CI] = 1.21 [1.08–1.36]) and a worse OS (adjusted hazard ratio, [95% CI] = 1.21 [1.06–1.37]). High nSES was associated with worse baseline bother (middle OR = 4.22 [1.11–16.09] and high 4.49 [1.16–17.43]) compared to low nSES. There was no association between AL or nSES and symptom burden at 5.5 months, non-completion of induction therapy or PFS. Additionally, there was no association between nSES and OS. AL may have utility as a predictive marker for OS among patients with MM and may allow individualization of treatment. Future studies should standardize and validate AL patients with MM.
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U2 - 10.1038/s41408-022-00648-y
DO - 10.1038/s41408-022-00648-y
M3 - Article
C2 - 35365604
AN - SCOPUS:85127404386
SN - 2044-5385
VL - 12
JO - Blood Cancer Journal
JF - Blood Cancer Journal
IS - 4
M1 - 53
ER -