There are disparities in outcomes for patients with multiple myeloma (MM). We evaluated the influence of sociodemographic factors on global disparities in outcomes for patients with MM. This rapid evidence assessment (PROSPERO, CRD42021248461) followed PRISMA-P guidelines and used the PICOS framework. PubMed and Embase® were searched for articles in English from 2011 to 2021. The title, abstract, and full text of articles were screened according to inclusion/exclusion criteria. The sociodemographic factors assessed were age, sex, race/ethnicity, socioeconomic status, and geographic location. Outcomes were diagnosis, access to treatment, and patient outcomes. Of 84 articles included, 48 were US-based. Worldwide, increasing age and low socioeconomic status were associated with worse patient outcomes. In the US, men typically had worse outcomes than women, although women had poorer access to treatment, as did Black, Asian, and Hispanic patients. No consistent disparities due to sex were seen outside the US, and for most factors and outcomes, no consistent disparities could be identified globally. Too few studies examined disparities in diagnosis to draw firm conclusions. This first systematic analysis of health disparities in patients with MM identified specific populations affected, highlighting a need for additional research focused on assessing patterns, trends, and underlying drivers of disparities in MM.
多发性骨髓瘤（MM）患者的临床结局存在差异。本研究评估了社会人口学因素对全球多发性骨髓瘤患者结局差异的影响。此次快速证据评估（PROSPERO注册号CRD42021248461）遵循PRISMA-P指南，采用PICOS框架进行。我们在PubMed和Embase®数据库中检索了2011年至2021年间发表的英文文献，并依据纳入/排除标准对文章的标题、摘要及全文进行筛选。评估的社会人口学因素包括年龄、性别、种族/民族、社会经济状况和地理区域；观察结局涵盖诊断、治疗可及性及患者临床结局。在纳入的84篇文献中，48篇基于美国数据。全球范围内，高龄和低社会经济状况与较差的临床结局相关。在美国，男性患者通常结局较差，而女性、黑人、亚裔和西班牙裔患者的治疗可及性更低。在美国以外的地区未发现与性别相关的系统性差异，且全球范围内大多数因素与结局之间未呈现一致的差异模式。由于涉及诊断差异的研究数量不足，无法得出明确结论。这项针对多发性骨髓瘤健康差异的首项系统性分析明确了受影响的具体人群，强调需要进一步开展研究，重点关注MM差异的模式、趋势及根本驱动因素。
Global disparities in patients with multiple myeloma: a rapid evidence assessment
肿瘤(癌症)患者之家