Multiple Myeloma in Hispanics: Incidence, Characteristics, Survival, Results of Discovery, and Validation Using Real-World and Connect MM Registry Data

Clin Lymphoma Myeloma Leuk. 2021 Apr;21(4):e384-e397. doi: 10.1016/j.clml.2020.11.013. Epub 2020 Nov 21.

Abstract

Background: Multiple myeloma (MM) in Hispanics has never been studied. We therefore sought to determine the clinical characteristics and overall survival in MM of Hispanics compared to non-Hispanic whites (NHW) and non-Hispanic blacks (NHB).

Patients and methods: A single-center analysis of 939 patients diagnosed with MM from 2000 to 2017 with a large representation of NHB (n = 489), Hispanics (n = 281), and NHW (n = 169) was conducted to evaluate outcomes and disease characteristics. We used the Connect MM Registry, a large US multicenter prospective observational study with newly diagnosed MM patients, as a validation cohort.

Results: Hispanics had a higher incidence of MM compared to NHW. The median age at presentation was 5 years younger (median, 65 years) in Hispanics compared to NHW (median, 70 years), and patients were more likely to present with renal dysfunction (estimated glomerular filtration rate < 30 mL/min). Hispanics had a higher proportion of Revised International Staging System (R-ISS) stage I disease compared to NHW and NHB (P = .03), while there was no difference in cytogenetics between Hispanics and NHB/NHW. In the multivariate analysis, only high-risk disease and response to first-line therapy significantly affected survival.

Conclusion: In this first and largest analysis of MM in Hispanics, we found that Hispanics present at a younger age, have a higher incidence of renal dysfunction, and have low R-ISS stage disease at presentation. With equal access to therapy, Hispanics have survival similar to NHW/NHB.

Keywords: African Americans; Healthcare disparities; Hispanic Americans; Incidence; Multiple myeloma.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Black or African American / statistics & numerical data
  • Female
  • Health Services Accessibility / organization & administration
  • Health Services Accessibility / statistics & numerical data*
  • Healthcare Disparities / statistics & numerical data*
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Multiple Myeloma / complications
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / epidemiology*
  • Multiple Myeloma / therapy
  • Prospective Studies
  • Registries / statistics & numerical data
  • Renal Insufficiency / epidemiology*
  • Renal Insufficiency / etiology
  • Survival Analysis
  • United States / epidemiology
  • White People / statistics & numerical data