Racial Disparities Myeloma Cohort within a Center of Excellence

Multiple myeloma (MM) is a hematologic malignancy of monoclonal plasma cells. African Americans have a higher incidence of MM than other races, and numerous studies have described potential disparities in cancer care. In this retrospective study, we investigated outcomes of MM within a single academic institution with a dedicated myeloma Center of Excellence. Data from a single academic institution’s cancer registry was analyzed for patients diagnosed with MM between 2015 and 2024. Demographic, treatment, and outcome data were collected. The association between survival and race was examined using bivariate analyses, a log-rank test, and both univariable and multivariable Cox proportional hazards modeling. No statistically significant differences in 1-, 3-, and 5-year survival rates between the racial groups were observed. Medicaid insurance, higher age at diagnosis, active cancer status, negative family history of cancer, decreased alcohol use, and higher comorbidity burden were found to be significantly associated with increased mortality, independent of race. Our study found that African Americans patients with MM treated at this single academic institution with a dedicated myeloma center had similar survival rates when compared to White patients. Centralized care and dedicated Centers of Excellence may help mitigate racial disparities in myeloma care.多发性骨髓瘤（multiple myeloma, MM）是一类单克隆浆细胞来源的血液系统恶性肿瘤。非裔美国人的多发性骨髓瘤发病率高于其他种族，且多项研究均已证实癌症诊疗领域存在潜在的种族差异。本项回顾性研究针对单家设有专属骨髓瘤卓越诊疗中心的学术医疗机构内的多发性骨髓瘤患者预后情况展开探究。我们分析了该机构癌症登记系统中2015年至2024年间确诊为多发性骨髓瘤的患者数据，收集了患者的人口统计学特征、治疗方案及预后相关资料。通过双变量分析、对数秩检验（log-rank test）以及单变量与多变量Cox比例风险回归模型，对患者生存情况与种族之间的关联进行了检验。研究未观察到不同种族组在1年、3年及5年生存率上存在统计学显著差异。分析结果显示，医疗补助保险（Medicaid）、确诊时年龄更高、活动性癌症状态、无癌症家族史、饮酒量减少以及合并症负担更高，均与死亡率升高显著相关，且该关联不受种族因素影响。本研究发现，在这家设有专属骨髓瘤卓越诊疗中心的学术医疗机构接受治疗的非裔美国多发性骨髓瘤患者，其生存率与白人患者无显著差异。集中化诊疗模式与专属卓越诊疗中心或有助于缓解骨髓瘤诊疗中的种族差异。