African Americans and Caucasians with Myeloma Have Similar Outcomes in the Current Era: A Tumor Registry Study.

Multiple myeloma is essentially an incurable disease, and SEER data suggests striking differences in survival between caucasians and African Americans. Recent advances in stem cell transplantation, however, can improve survival. To determine whether survivals continue to differ between caucasians and African Americans in the era of stem cell transplantation, we performed a retrospective analysis of 474 patients identified from a hospital tumor registry with a diagnosis of myeloma made consecutively from 1981 to 2000. The study cohort was comprised of 238 African Americans and 236 caucasians. Seven patients were lost in follow-up while still alive, and the remainder have either died or have follow-up to within one year of the analysis. There were 239 females and 235 males, and the distribution by gender did not differ by race (p=0.93). Median age of the cohort was 70 years (range 30–95 years); 6.5% were <50 years old, 67.9% 51–75 years old, and 25.5% >75 years old. The distribution by age differed significantly by race. A higher proportion of African Americans were diagnosed when <50 years old or when >75 years old in comparison to caucasians (p=0.006). Median survival for the entire cohort was 2.07 years, 1.92 years for African Americans and 2.31 years for caucasians (p=0.475). The difference in survival was essentially limited to patients diagnosed prior to 1996 (1.84 years vs 2.33 years, p=0.02). For patients diagnosed 1996–2000, the median survivals were similar (2.27 years vs 2.03 years, p=0.89). In a multivariate analysis, increasing age group was significantly predictive of poorer survival, but race, gender and quartile of year of diagnosis were not independent risk factors. We conclude that race is no longer associated with poorer survival for patients with myeloma.