Addressing the disparities: the approach to the African American patient with multiple myeloma (https://www.myeloma.org/resource-library/addressing-disparities-approach-african-american-patient-multiple-myeloma)
This document discusses the disparities faced by African American patients with multiple myeloma in terms of incidence, timely diagnosis, access to treatment, clinical trial participation, and healthcare utilization. The disparities are influenced by both biologic and non-biologic factors. Biologic disparities include hereditary and familial susceptibility, obesity and related risk factors, different disease biology, and clinical characteristics. Non-biologic disparities include systemic racism, socioeconomic and lifestyle disparities, delay in diagnosis, and disparities in access to quality care and clinical trials. The document emphasizes the need for healthcare providers to address these disparities and provide equitable care to African American patients with multiple myeloma.
Important Points:
- African American patients with multiple myeloma face significant disparities in incidence, timely diagnosis, access to treatment, clinical trial participation, and healthcare utilization.
- The disparities are influenced by both biologic and non-biologic factors.
- Biologic disparities include hereditary and familial susceptibility, obesity and related risk factors, different disease biology, and clinical characteristics.
- African American individuals have a higher incidence of multiple myeloma and its precursor condition monoclonal gammopathy of undermined significance (MGUS) compared to White individuals.
- African American patients have a higher prevalence of autosomal dominantly inherited hyperphosphorylated form of the paratarg-7 protein (pP-7) carriers.
- African American patients have distinct biological subtypes with a range of molecular and genetic features, including a lower incidence of high-risk genomic profile.
- African American patients have lower levels of monoclonal protein, an earlier age of onset, and a higher frequency of abnormal serum free light chain (sFLC) ratios.
- Non-biologic disparities include systemic racism, socioeconomic and lifestyle disparities, delay in diagnosis, and disparities in access to quality care and clinical trials.
- African American individuals have lower median incomes, are more likely to be unemployed, work low paying jobs, and often earn less for the same level of expertise.
- African American patients experience a delay in diagnosis and treatment, potentially due to reduced access to primary care, mistrust in the healthcare system, financial barriers, poor physician-patient communication, and physician bias.
- African American patients are less likely to receive novel therapies and more likely to undergo autologous stem cell transplantation (ASCT) later in their disease course.
- African American patients are underrepresented in clinical trials, genomic sequencing databases, and specimen acquisition studies.
- The disparities highlight the need for healthcare providers to address these issues and provide equitable care to African American patients with multiple myeloma.
Authors:
Manisha Bhutani, Brandon J. Blue, Craig Cole, Ashraf Z. Badros, Saad Z. Usmani, Ajay K. Nooka, Leon Bernal-Mizrachi, Joseph Mikhael, Brian J. Bolwell, Charles Cleeland, Sikander Ailawadhi, and Luciano J. Costa.
Citation:
Bhutani et al. Blood Cancer Journal, 3(189)
https://doi.org/10.1038/s41408-023-00961-0 (https://doi.org/10.1038/s41408-023-00961-0)