Multiple Myeloma in the Culturally and Linguistically Diverse Southwestern Sydney, Australia

Multiple myeloma (MM) is an incurable haematological cancer with a median overall survival of 5 to 10 years. Multiple American studies have reported significant disparities in the incidence and clinical outcomes in MM patients that may be explained by race or ethnicity.

This study sought to characterise the racial/ethnic representation in myeloma patients who presented to the public hospitals in Southwestern Sydney between 2009 and 2020. This retrospective study describes the associations between race/ethnicity and age at diagnosis, cytogenetics, comorbidities, and survival outcomes.

Data for analysis was extracted from Mosaiq (electronic medical record system for oncology workflow management) and PathNet® (laboratory information system). Since neither race nor ethnicity are recorded in the NSW Healthcare system, race was defined based on the country of birth while ethnicity was defined as culturally and linguistically diverse (CALD), based on country of birth and language as well as use of an interpreter.

Seven regions of birth across 65 countries of birth and five CALD groups were identified in our cohort, with 26% of the cohort speaking a language other than English. Survival outcomes were similar regardless of race or CALD classification. Analysis of the cytogenetics and comorbidities are still in progress.

This is the first reported racial study in MM in NSW. The preliminary results presented here demonstrates that automatically classifying patients as Caucasian, solely based on country of birth can be misleading. In a multicultural region like Southwestern Sydney, it is important to consider patients' cultural and linguistic background.