文章：

剖析多发性骨髓瘤中的种族差异

Dissecting racial disparities in multiple myeloma

原文发布日期：2020-02-17

DOI: 10.1038/s41408-020-0284-7

类型: Review Article

开放获取: 是

英文摘要：

Multiple myeloma (MM) is a fatal plasma cell dyscrasia with a median overall survival of 5 to 10 years. MM progresses from the more common but often subclinical precursor states of monoclonal gammopathy of undetermined significance (MGUS), and smoldering multiple myeloma (SMM) to overt MM. There are large racial disparities in all stages of the disease. Compared with Whites, Blacks have an increased MGUS and MM risk and higher mortality rate, and have not experienced the same survival gains over time. The roots of this disparity are likely multifactorial in nature. Comparisons of Black and White MGUS and MM patients suggest that differences in risk factors, biology, and clinical characteristics exist by race or ancestry, which may explain some of the observed disparity in MM. However, poor accrual of Black MGUS and MM patients in clinical and epidemiological studies has limited our understanding of this disparity and hindered its elimination. Disparities in MM survival also exist but appear to stem from inferior treatment utilization and access rather than underlying pathogenesis. Innovative and multidisciplinary approaches are urgently needed to enhance our understanding of disparities that exist at each stage of the MM disease continuum and facilitate their elimination.
 

摘要翻译： 

多发性骨髓瘤（MM）是一种致命的浆细胞恶液质，中位总生存期为5至10年。该疾病从更常见但常处于亚临床阶段的前驱状态——意义未明的单克隆丙种球蛋白病（MGUS）和闷燃型多发性骨髓瘤（SMM）——逐步进展为显性多发性骨髓瘤。该疾病各阶段均存在显著的种族差异。与白人相比，黑人罹患MGUS和MM的风险更高，死亡率也更严重，且随时间推移未能获得同等的生存改善。这种差异的根源很可能涉及多重因素。对黑人与白人MGUS及MM患者的比较研究表明，不同种族或族裔在风险因素、生物学特征和临床表现方面存在差异，这或许能解释部分观察到的MM生存差异。然而，由于黑人在临床与流行病学研究中的参与度不足，限制了我们对此差异的深入理解，并阻碍了消除差异的进程。MM生存率差异确实存在，但其根源似乎在于治疗利用与获取途径的不足，而非潜在病理机制差异。当前亟需采用创新性多学科方法，以加深对MM疾病连续进程各阶段差异的理解，并推动其消除。

原文链接：

Dissecting racial disparities in multiple myeloma