文章：

多发性骨髓瘤治疗与结局的种族差异：多发性骨髓瘤研究基金会分析报告

Racial differences in treatment and outcomes in multiple myeloma: a multiple myeloma research foundation analysis

原文发布日期：2020-08-07

DOI: 10.1038/s41408-020-00347-6

类型: Article

开放获取: 是

英文摘要：

Findings on racial differences in survival in multiple myeloma (MM) have been inconclusive. We assessed differences in outcomes between White and Black individuals among 639 newly diagnosed MM patients in the MM Research Foundation CoMMpass registry with baseline cytogenetic data. Survival curves were constructed using the Kaplan–Meier method. Hazard ratios and 95% confidence intervals were derived from Cox proportional hazard regression models. Age, gender, and stage were similar between Whites (n = 526) and Blacks (n = 113). Blacks had inferior overall survival (OS) compared with Whites and were less likely to receive triplet therapies or frontline autologous stem cell transplant (ASCT). The following factors were significantly associated with inferior OS in multivariate analysis: higher international staging system (ISS) score, ≥1 or ≥2 high-risk cytogenetic abnormalities (HRCA), high-risk gene expression profile (GEP), and lack of ASCT. Multivariate analysis in the Black subset found that only lack of ASCT was significantly associated with inferior OS. The receipt of both triplet induction and ASCT only partly abrogated the effect of race on survival. HRCA did not track with survival in Blacks, emphasizing the need for race-specific risk prognostication schema to guide optimal MM therapy.
 

摘要翻译： 

关于多发性骨髓瘤（MM）患者生存率的种族差异研究尚无定论。我们评估了MM研究基金会CoMMpass登记中639名新诊断MM患者（拥有基线细胞遗传学数据）中白人与黑人患者的预后差异。采用Kaplan-Meier法绘制生存曲线，风险比和95%置信区间通过Cox比例风险回归模型计算。白人（526例）与黑人（113例）患者在年龄、性别和分期方面具有相似性。与白人相比，黑人患者总生存期（OS）更短，接受三联疗法或一线自体干细胞移植（ASCT）的可能性更低。多变量分析显示以下因素与OS降低显著相关：较高的国际分期系统（ISS）评分、≥1或≥2种高危细胞遗传学异常（HRCA）、高危基因表达谱（GEP）以及未接受ASCT。在黑人亚组的多变量分析中，仅未接受ASCT与OS降低显著相关。三联诱导疗法与ASCT的联合应用仅部分消除了种族对生存率的影响。HRCA在黑人患者中未显示与生存率的相关性，这强调需要建立针对特定种族的风险预后体系以指导MM的优化治疗。

原文链接：

Racial differences in treatment and outcomes in multiple myeloma: a multiple myeloma research foundation analysis