Racial disparities in treatment patterns and outcomes among patients with multiple myeloma: A SEER-Medicare analysis

Sikander Ailawadhi, Kejal Parikh, Safiya Abouzaid, Zhou Zhou, Wenxi Tang, Zoe Clancy, Claudia Cheung, Zheng Yi Zhou, Jipan Xie

Research output: Contribution to journalArticle

Abstract

The objective of the study was to assess racial disparities in the treatment and outcomes among white, African American, and Hispanic patients with multiple myeloma (MM). Patients with an MM diagnosis from the Surveillance Epidemiology and End Results (SEER)–Medicare (2007-2013) database were included. Continuous Medicare enrollment for 6 months before (baseline) and after MM diagnosis was required unless death occurred. Time from MM diagnosis to novel therapy initiation and autologous stem cell transplant (ASCT), overall survival (OS), and MM-specific survival (MSS) was evaluated. Unadjusted and multivariable regressions compared African Americans and Hispanics vs whites. Trends of novel therapy and ASCT use across MM diagnosis years were assessed using linear regression models. The study included 3504 whites, 858 African Americans, and 468 Hispanics. African Americans and Hispanics had a longer time from MM diagnosis to novel therapy initiation vs whites (median: 5.2 and 4.6 vs 2.7 months, respectively). All cohorts had an increasing trend of novel therapy initiation within 6 months of MM diagnosis, particularly whites (all P, .05). Median MSS was significantly longer for African Americans (5.4 years) than whites (4.5 years; P, .05), and was comparable for Hispanics and whites. Median OS was similar overall (2.6-2.8 years). ASCT rate within 1 year of MM diagnosis rose among whites and African Americans (P, .05), but not Hispanics, who were less likely to receive ASCT vs whites. Significant variations in novel therapy and ASCT use were observed among different racial/ethnic groups with MM. Although OS was similar, both African Americans and Hispanics may not be fully benefitting from the introduction of novel therapies, as they receive them later than whites.

Original languageEnglish (US)
Pages (from-to)2986-2994
Number of pages9
JournalBlood Advances
Volume3
Issue number20
DOIs
StatePublished - Oct 22 2019

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Medicare
Multiple Myeloma
Epidemiology
Hispanic Americans
African Americans
Stem Cells
Transplants
Survival
Linear Models
Therapeutics
Ethnic Groups
Databases

ASJC Scopus subject areas

  • Hematology

Cite this

Racial disparities in treatment patterns and outcomes among patients with multiple myeloma : A SEER-Medicare analysis. / Ailawadhi, Sikander; Parikh, Kejal; Abouzaid, Safiya; Zhou, Zhou; Tang, Wenxi; Clancy, Zoe; Cheung, Claudia; Zhou, Zheng Yi; Xie, Jipan.

In: Blood Advances, Vol. 3, No. 20, 22.10.2019, p. 2986-2994.

Research output: Contribution to journalArticle

Ailawadhi, S, Parikh, K, Abouzaid, S, Zhou, Z, Tang, W, Clancy, Z, Cheung, C, Zhou, ZY & Xie, J 2019, 'Racial disparities in treatment patterns and outcomes among patients with multiple myeloma: A SEER-Medicare analysis', Blood Advances, vol. 3, no. 20, pp. 2986-2994. https://doi.org/10.1182/bloodadvances.2019000308
Ailawadhi, Sikander ; Parikh, Kejal ; Abouzaid, Safiya ; Zhou, Zhou ; Tang, Wenxi ; Clancy, Zoe ; Cheung, Claudia ; Zhou, Zheng Yi ; Xie, Jipan. / Racial disparities in treatment patterns and outcomes among patients with multiple myeloma : A SEER-Medicare analysis. In: Blood Advances. 2019 ; Vol. 3, No. 20. pp. 2986-2994.
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