This retrospective observational study evaluated racial disparities among Black and White patients with multiple myeloma (MM). We included patients from a longitudinal de-identified EHR-derived database who had ≥2 visits recorded on or after 1/1/2011, documented treatment, and race listed as White or Black. Black patients (n = 1172) were more likely female (54.8%/42.9%) and younger (<65 years, 40.8%/30.8%) than White patients (n = 4637). Unadjusted median real-world overall survival (rwOS) indexed to first-line of therapy (LOT) was 64.6 months (95% CI: 57.8–74.0) for Blacks and 54.5 months (95% CI: 50.9–56.2) for Whites. Adjusted rwOS estimates (for sex, age at index date, and practice type) to either first- (aHR = 0.94; 95% CI: 0.84–1.06) or second-LOT (aHR = 0.90; 95% CI: 0.77–1.05) were similar. Unadjusted derived response rate (dRR) during first-LOT was 84.8% (95% CI: 80.7–88.1) for Blacks and 86.9% (95% CI: 85.0–88.5) for Whites (odds ratio [OR] = 0.78 [95% CI: 0.57–1.10]); in second-LOT, 67.2% (95% CI: 58.4–75.0) for Blacks and 72.4% (95% CI: 68.1–76.3) for Whites (OR = 0.72 [95% CI: 0.46–1.13]). High representation of Black patients enabled this robust analysis, albeit with limitations inherent to the observational data source, the retrospective design, and the analytic use of newly derived endpoints requiring further validation.
这项回顾性观察研究评估了黑人与白人多发性骨髓瘤患者之间的种族差异。我们纳入了来自纵向去标识化电子健康记录数据库的患者，这些患者在2011年1月1日或之后至少有两次就诊记录、有明确治疗记录且种族标注为白人或黑人。与白人患者（n=4637）相比，黑人患者（n=1172）中女性比例更高（54.8%/42.9%），年龄更小（<65岁者占40.8%/30.8%）。以一线治疗为起始点的未调整中位真实世界总生存期，黑人为64.6个月（95% CI：57.8-74.0），白人为54.5个月（95% CI：50.9-56.2）。经调整（针对性别、起始点年龄和实践类型）后的一线治疗（aHR=0.94；95% CI：0.84-1.06）或二线治疗（aHR=0.90；95% CI：0.77-1.05）的真实世界总生存期估计值相似。一线治疗期间未调整的衍生缓解率，黑人为84.8%（95% CI：80.7-88.1），白人为86.9%（95% CI：85.0-88.5）（比值比[OR]=0.78 [95% CI：0.57-1.10]）；在二线治疗中，黑人为67.2%（95% CI：58.4-75.0），白人为72.4%（95% CI：68.1-76.3）（OR=0.72 [95% CI：0.46-1.13]）。黑人患者的高比例代表性使这一稳健分析成为可能，尽管研究存在观察性数据源、回顾性设计以及新衍生终点需进一步验证等固有局限性。
肿瘤(癌症)患者之家