Race and outcomes of autologous hematopoietic cell transplantation for multiple myeloma.
Blacks are twice as likely to develop and die from multiple myeloma (MM), and are less likely to receive an autologous hematopoietic-cell transplant (AHCT) for MM compared to Whites. The influence of race on outcomes of AHCT for MM is not well described. We compared the probability of overall survival (OS), progression-free survival (PFS), disease progression, and nonrelapse mortality (NRM) among Black (N=303) and White (N=1892) recipients of AHCT for MM, who were reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) from 1995 to 2005. The Black cohort was more likely to be female, and had better Karnofsky performance scores, but lower hemoglobin and albumin levels at diagnosis. Black recipients were younger and more likely to be transplanted later in their disease course. Disease stage and treatment characteristics prior to AHCT were similar between the 2 groups. Black and White recipients had similar probabilities of 5-year OS (52% versus 47%, P=.19) and PFS (19% versus 21%, P=.64) as well as cumulative incidences of disease progression (72% versus 72%, P=.97) and NRM (9% versus 8%, P=.52). In multivariate analyses, race was not associated with any of these endpoints. Black recipients of AHCT for MM have similar outcomes compared to Whites, suggesting that the reasons underlying lower rates of AHCT in Blacks need to be studied further to ensure equal access to effective therapy.
Hari
Parameswaran N
PN
Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA. phari@mcw.edu
Majhail
Navneet S
NS
Zhang
Mei-Jie
MJ
Hassebroek
Anna
A
Siddiqui
Fareeha
F
Ballen
Karen
K
Bashey
Asad
A
Bird
Jenny
J
Freytes
Cesar O
CO
Gibson
John
J
Hale
Gregaory
G
Holmberg
Leona
L
Kamble
Ram
R
Kyle
Robert A
RA
Lazarus
Hillard M
HM
LeMaistre
Charles F
CF
Loberiza
Fausto
F
Maiolino
Angelo
A
McCarthy
Philip L
PL
Milone
Gustavo
G
Omondi
Nancy
N
Reece
Donna E
DE
Seftel
Matthew
M
Trigg
Michael
M
Vesole
David
D
Weiss
Brendan
B
Wiernik
Peter
P
Lee
Stephanie J
SJ
Rizzo
J Douglas
JD
Mehta
Paulette
P
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D018572:Disease-Free Survival; D004358:Drug Therapy / Q000706:statistics & numerical data; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D044469:Racial Groups / Q000706:statistics & numerical data*; D012008:Recurrence; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D044465:White People / Q000706:statistics & numerical data