Prevalence, incidence and survival of smoldering multiple myeloma in the United States

Ravindran, Aishwarya; Bartley, Adam C.; Holton, Sara; Gonsalves, Wilson I.; Kapoor, Prashant; Siddiqui, Mustaqeem; Hashmi, Shahrukh K.; Marshall, Ariela L.; Ashrani, Aneel A.; Dispenzieri, Angela; Kyle, Robert A.; Rajkumar, S. Vincent; Go, Ronald S.

doi:10.1038/bcj.2016.100

Cited by 57 publications

(53 citation statements)

References 11 publications

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“…In addition, there is a small minority of patients with MM with asymptomatic or “smoldering” disease who do not require treatment; to the best of our knowledge, there currently is no validated claims‐based method with which to identify them. However, the incidence of asymptomatic MM is similar between white and black patients and therefore should not confound comparisons of racial differences . Another limitation of the current analysis is the lack of direct measures of SES and PS, and the use of surrogates for these measures.…”

Section: Discussionmentioning

confidence: 98%

“…However, the incidence of asymptomatic MM is similar between white and black patients and therefore should not confound comparisons of racial differences. 19 Another limitation of the current analysis is the lack of direct measures of SES and PS, and the use of surrogates for these measures. In addition, the database lacks any proxy variable for the success of stem cell mobilization.…”

Section: Discussionmentioning

confidence: 99%

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Racial disparities in treatment use for multiple myeloma

Fiala

Wildes

2017

Cancer

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Background Recent treatment advances have greatly improved the prognosis of patients with multiple myeloma. However, some of these newer, more effective treatments are intensive and expensive and their utilization is still low, particularly among black patients. Methods In this study, we reviewed the utilization patterns of stem cell transplantation and bortezomib using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Results After controlling for overall health and potential access barriers, black patients were 37% (p < 0.0001) less likely to utilize stem cell transplantation, and 21% (p< 0.0001) less likely to utilize bortezomib. Moreover, we found that the underutilization of these agents was the associated with a 12% (p = 0.0007) increase in hazard ratio for death among black patients. Conclusion Eliminating health disparities, a current focus of U.S. public policy, is highly complex, as illustrated by the results of this study. In patients with multiple myeloma, treatment disparities are not completely explained by potential access barriers. Additional factors, such as structural barriers in the health care system and individual decision-making among black and white patients, must be explored to fully explain the disparity.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Racial disparities in treatment use for multiple myeloma

Fiala

Wildes

2017

Cancer

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“…In fact, a recent analysis based on the National Cancer Database (NCDB) found that ;1 in 7 MM cases in the United States can be defined as SMM and noted increase in survival of SMM patients between 2003 and 2007 and 2008 and 2011. 20 Unfortunately, SEER does not distinguish between smoldering and active cases of MM, preventing us from further detailing the analysis.…”

Section: Discussionmentioning

confidence: 99%

Recent trends in multiple myeloma incidence and survival by age, race, and ethnicity in the United States

Costa¹,

Brill

Omel³

et al. 2017

Blood Advances

248

214

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“…However, we used a previously published algorithm by Ravindran et al to remove patients with potential smoldering MM from the NCDB. 7 Fifth, the educational level in the NCDB, defined as the percentage of individuals with ≥high school education residing in the neighborhood, may not reflect the personal educational level. Sixth, the percentage of individuals with residence in a rural area in the NCDB (2%-3%) was marginal, and the majority of the rural area residents treated in CoC-accredited cancer centers were likely healthy enough to be transferred or had better health literacy.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of long‐term survivors with multiple myeloma: A National Cancer Data Base analysis

Hsieh

Abeykoon

et al. 2019

Cancer

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BACKGROUND: There exist insufficient data characterizing patients with multiple myeloma (MM) who experienced prolonged survival. A population-based analysis of long-term survivors was conducted to investigate the roles of sociodemographic factors and upfront stem cell transplantation (SCT). METHODS: The National Cancer Data Base is a US cancer database of approximately 34 million patients from >1500 cancer centers. Patients with MM were identified using the International Classification of Diseases for Oncology (ICD-O) code 9732 from January 2004 to December 2006 and were divided into 4 groups based on overall survival (OS). Sociodemographic characteristics, treatment facility, and use of SCT were recorded. The univariate and multivariate analyses were performed using multiple logistic regression and Pearson chi-square tests. RESULTS: A total of 26,986 patients with MM were identified. The median OS was 2.74 years. The majority of patients were male (54%), white (77%), insured (93%) and otherwise healthy (78%), lived in a metropolitan area (82%), were of high income (66%) and educational (58%) levels, and received treatment at nonacademic facilities (63%). Upfront SCT was used in 10% of patients. One in 6 patients (16%) were long-term survivors (group 4). When comparing group 4 (OS of ≥8.22 years) with the other groups (OS of <8.22 years), young age, female sex, high income and educational levels, residence in a rural area, insured status, no comorbidity, receipt of upfront SCT, and treatment at high-volume facilities were associated with long-term survival. CONCLUSIONS: Key differences in sociodemographic characteristics, patient volume at treatment facilities, and upfront SCT were associated with long-term survival. Improvements in health care access and health literacy, upfront SCT, and treatment at high-volume facilities might prolong patient survival. Cancer 2019;125:3574-3581.

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Prevalence, incidence and survival of smoldering multiple myeloma in the United States

Cited by 57 publications

References 11 publications

Racial disparities in treatment use for multiple myeloma

Racial disparities in treatment use for multiple myeloma

Recent trends in multiple myeloma incidence and survival by age, race, and ethnicity in the United States

Characteristics of long‐term survivors with multiple myeloma: A National Cancer Data Base analysis

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