BOSTON—A recent VA study has shed new light on racial disparities in multiple myeloma.
“Previous work examined survival and treatment in multiple myeloma in the broader U.S. healthcare system and found disparities in survival,” said study co-author Nathanael Fillmore, PhD, associate director for Machine Learning and Predictive Analytics at the VA Boston Healthcare System and instructor in medicine at Harvard Medical School. The study was presented recently at the 61st American Society of Hematology Annual Meeting and Exposition in Orlando.1
Multiple myeloma is the most common hematologic malignancy. The VA has treated 15,700 veterans with the disease since 1999. More than 1,000 veterans are newly diagnosed each year, Fillmore told U.S. Medicine.
Fillmore and his colleagues sought to determine whether the disease had similar outcomes in black and white veterans and, if not, what drove the difference.
Multiple myeloma affects blacks at twice the rate of whites and develops at an earlier age, with a median age of 65.8 years at diagnosis in blacks compared to 69.8 years in whites.2 A number of studies have found that black patients start novel therapies later than white patients and are referred for transplants later than their white counterparts.3
Despite these differences, five-year survival rates are slightly higher for blacks than whites, 51% vs. 50% in men and 53% vs. 50% in women.4
Still, it hasn’t always been clear whether blacks or whites have the survival advantage, with studies splitting on the issue.
Among veterans, however, the answer is clear. “In the VA, survival is about the same or African American patients do better,” he said. “In the VA, unlike the broader healthcare system, treatment is generally similar and, in the context of equal access, outcomes are better for younger African American patients than younger European Americans.”
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