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The impact of race on outcomes of autologous transplantation in patients with multiple myeloma.
Am J Hematol. 2008 May; 83(5):355-8.AJ

Abstract

Multiple myeloma is the most common hematologic malignancy in African-Americans, with twice the mortality of Caucasians according to population based data. In the pretransplantation era, comparable conventional therapy has resulted in similar outcomes between African-Americans and Caucasians. However, there has been limited data on outcomes after high dose chemotherapy with autologous stem cell transplantation (ASCT). A retrospective analysis of Caucasian (n = 55) and African-American (n = 36) myeloma patients who underwent ASCT in an equal access health care system in the Department of Defense was performed. Presenting demographic variables, pre/post ASCT characteristics, overall mortality and relapse rates after ASCT were obtained. Progression-free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier, and compared via log-rank testing. The median age at diagnosis for African-Americans = 52 years, Caucasians = 56 years (P = 0.009). There were no differences in presenting ISS stage, hemoglobin, calcium, or creatinine. African-Americans presented with higher CRP levels (P = 0.005), and a trend for less skeletal involvement (P = 0.10). Response to induction and ASCT was similar. Median PFS was 60.5 months (95% CI: 31.3-89.8 months) for African-Americans, 43.7 months (95% CI: 33.9-53.5 months) for Caucasians, HR of 1.3 (95% CI: 0.7-2.4), P = 0.46. Median OS was 95.2 months (95% CI: N/A) for African-Americans, 68.5 months (95% CI: 14.2-122.9 months) for Caucasians, HR of 1.4 (95% CI: 0.7-2.9), P = 0.41. In a cohort of myeloma patients who received autologous transplantation in an equal access health care system, there was comparable survival between African-Americans and Caucasians, suggesting that the historical increased mortality for African-Americans may be due to inequalities in access to care.

Authors+Show Affiliations

Hematology and Oncology Service, Department of Medicine, Walter Reed Army Medical Center, NW Washington, District of Columbia 20307-500, USA. pramvir@hotmail.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18186525

Citation

Verma, Pramvir S., et al. "The Impact of Race On Outcomes of Autologous Transplantation in Patients With Multiple Myeloma." American Journal of Hematology, vol. 83, no. 5, 2008, pp. 355-8.
Verma PS, Howard RS, Weiss BM. The impact of race on outcomes of autologous transplantation in patients with multiple myeloma. Am J Hematol. 2008;83(5):355-8.
Verma, P. S., Howard, R. S., & Weiss, B. M. (2008). The impact of race on outcomes of autologous transplantation in patients with multiple myeloma. American Journal of Hematology, 83(5), 355-8. https://doi.org/10.1002/ajh.21139
Verma PS, Howard RS, Weiss BM. The Impact of Race On Outcomes of Autologous Transplantation in Patients With Multiple Myeloma. Am J Hematol. 2008;83(5):355-8. PubMed PMID: 18186525.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of race on outcomes of autologous transplantation in patients with multiple myeloma. AU - Verma,Pramvir S, AU - Howard,Robin S, AU - Weiss,Brendan M, PY - 2008/1/12/pubmed PY - 2008/6/11/medline PY - 2008/1/12/entrez SP - 355 EP - 8 JF - American journal of hematology JO - Am J Hematol VL - 83 IS - 5 N2 - Multiple myeloma is the most common hematologic malignancy in African-Americans, with twice the mortality of Caucasians according to population based data. In the pretransplantation era, comparable conventional therapy has resulted in similar outcomes between African-Americans and Caucasians. However, there has been limited data on outcomes after high dose chemotherapy with autologous stem cell transplantation (ASCT). A retrospective analysis of Caucasian (n = 55) and African-American (n = 36) myeloma patients who underwent ASCT in an equal access health care system in the Department of Defense was performed. Presenting demographic variables, pre/post ASCT characteristics, overall mortality and relapse rates after ASCT were obtained. Progression-free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier, and compared via log-rank testing. The median age at diagnosis for African-Americans = 52 years, Caucasians = 56 years (P = 0.009). There were no differences in presenting ISS stage, hemoglobin, calcium, or creatinine. African-Americans presented with higher CRP levels (P = 0.005), and a trend for less skeletal involvement (P = 0.10). Response to induction and ASCT was similar. Median PFS was 60.5 months (95% CI: 31.3-89.8 months) for African-Americans, 43.7 months (95% CI: 33.9-53.5 months) for Caucasians, HR of 1.3 (95% CI: 0.7-2.4), P = 0.46. Median OS was 95.2 months (95% CI: N/A) for African-Americans, 68.5 months (95% CI: 14.2-122.9 months) for Caucasians, HR of 1.4 (95% CI: 0.7-2.9), P = 0.41. In a cohort of myeloma patients who received autologous transplantation in an equal access health care system, there was comparable survival between African-Americans and Caucasians, suggesting that the historical increased mortality for African-Americans may be due to inequalities in access to care. SN - 1096-8652 UR - https://www.unboundmedicine.com/medline/citation/18186525/The_impact_of_race_on_outcomes_of_autologous_transplantation_in_patients_with_multiple_myeloma_ L2 - https://doi.org/10.1002/ajh.21139 DB - PRIME DP - Unbound Medicine ER -