The impact of race on outcomes of autologous transplantation in patients with multiple myeloma
Article first published online: 10 JAN 2008
Copyright © 2008 Wiley-Liss, Inc.
American Journal of Hematology
Volume 83, Issue 5, pages 355–358, May 2008
How to Cite
Verma, P. S., Howard, R. S. and Weiss, B. M. (2008), The impact of race on outcomes of autologous transplantation in patients with multiple myeloma. Am. J. Hematol., 83: 355–358. doi: 10.1002/ajh.21139
- Issue published online: 16 APR 2008
- Article first published online: 10 JAN 2008
- Manuscript Accepted: 3 DEC 2007
- Manuscript Revised: 29 NOV 2007
- Manuscript Received: 13 JUN 2007
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. Am. J. Hematol., 2008. © 2008 Wiley-Liss, Inc.