MM-281 Disparities in Multiple Myeloma Between Hispanics and Non-Hispanics–Real World Outcomes

Hira Shaikh; Vutha Nhim; Alfonso Bencomo-Alvarez; Anna Eiring

doi:10.1016/S2152-2650(22)01612-3

Context: Multiple myeloma (MM) is the second most common hematological malignancy in the USA, constituting 1.8% of new cases (SEER database). It is a heterogeneous disease that is influenced by sociodemographic factors, with poor survival in non-Hispanic (NH) Blacks and Whites (Pulte et al. 2014). But, clinical characteristics and outcomes of MM are not well understood in Hispanics, one of the fastest-growing populations in the US. Methods: We used the Texas Cancer Registry to evaluate the differences between Hispanic and NH MM patients diagnosed between 1996 to 2016. Socio-demographic characteristics including ethnicity, gender, age, comorbidities, and primary payer were evaluated. Ethnicity was identified as Hispanic and non-Hispanic, and the race as Whites, Blacks, and American Indians. Statistical analysis was performed using SAS software. Hazard ratios (HR) for death and corresponding 95% confidence intervals (CI) were estimated using the cox proportional hazard model. Results: We found 5115 Hispanic and 22426 NH MM patients satisfying the inclusion criteria. Hispanics were diagnosed with MM at a younger age compared to NH (mean (CI) - 65.2 (12.4) vs 68.0 (11.8), P<0.001). Hispanic ethnicity was associated with poor survival after controlling for age at diagnosis, gender, race, and treatment (HR death 1.19, P=0.001). Additionally, increasing age at diagnosis correlated with higher mortality (HR 1.88 in 51-65 years old (yo), HR 2.65 in 66-79 yo, and HR 4.30 in 80+ yo, P=0.001), while females (HR 0.85, P=0.001) and transplant recipients (HR 0.5, P=0.001) had better survival on multivariate cox regression analysis. Blacks (HR 1.17) and American Indians (HR 1.13) did worse when compared with Whites, however, the difference was not statistically significant. Moreover, patients with private insurance had better outcomes than uninsured or Medicare insured (HR 0.85, P=0.049) when controlled for other covariates. Conclusions: To our knowledge, this is the largest analysis reporting outcomes of MM in Hispanics in the USA. While the study is limited by its retrospective nature, the recognition that outcomes in MM patients are impacted by ethnicity is important, which could be related to our findings of earlier age at diagnosis in Hispanics. These data highlight the need for improved access to equitable healthcare and clinical trials for Hispanics.

MM-281 Disparities in Multiple Myeloma Between Hispanics and Non-Hispanics–Real World Outcomes

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