Outcome of Upfront Autologous Peripheral Blood Stem Cell Transplantation for Multiple Myeloma in African American Versus Non Non-African American Patients.

Introduction:

Blacks in the United States are twice as likely to suffer from multiple myeloma as whites. Among African Americans, myeloma is one of the top 10 leading causes of cancer death. Although Multiple Myeloma seems to be more aggressive in African Americans, it is not known if they have worse outcome after autologous peripheral blood stem cell transplantation in comparison to Non African American.

Method:

We performed a retrospective analysis of 86 consecutive patients with Multiple Myeloma who underwent autologous peripheral blood stem cell transplantation between July 1991 and November 2004. Thirty two Patients were African American (37.21%) and fifty four patients were Non-African American (62.79%.). Conditioning regimen was Melphalan-200 in 57 patients and Melphalan140/TBI in 29 patients. No significant statistical differences were observed between African Americans and non African Americans prior to the transplant regarding gender, regimen used, immunoglobulin subtype, cytogenetics, stage, or disease status on univariate analysis.

Results:

There was no significant statistical difference in overall survival or event free survival between African American and non African American. However African American were observed to relapse significantly earlier than non African- American (p=0.0274). Despite the early relapse in African American, survival after relapse was longer for African American compared to non African American (p=0.060), however this result was only marginally significant.

Conclusion:

In this single institution experience, there was no difference in the OS or DFS after upfront autologous peripheral blood stem cell transplantation for Multiple Myeloma in African American and non- African American patients. Although time to progression was significantly shorter in African American versus non African American, surprisingly this was not associated with shorter survival. Despite that these results are limited by the sample size; they are intriguing and need further testing in larger group of patients.