Impact of Location, Age, Socio-Economic Status, and Race on Myeloma Outcomes

Dr. Ashley Rosko presents a study to determine the combined impact of location, age, socio-economic status, and race on transplant access and overall survival.

Abstract title:

Multiple Myeloma Transplant: Examining the Intersection of Access, Age and Race

Purpose of the trial:

The objective of the study was to examine the effect of age, race, location, and socio-economic status on the accessibility to Autologous Stem Cell Transplant (ASCT), the standard initial treatment for patients newly diagnosed with Multiple Myeloma (MM), and overall survival after the diagnosis of MM. The study aimed to determine the combined impact of these factors on transplant access and overall survival, which has not been fully established.

Video summary:

An IRB approved retrospective analysis was conducted of adult MM patients diagnosed in 1992-2020 from The Ohio State University Comprehensive Cancer Center (OSUCCC). Patients included were previously consented to the Buckeye Surveillance, Contact, and Research for Multiple Myeloma and Amyloidosis Protocol (NCT01408225); a registry database for patients with suspected plasma cell dyscrasia pursuing care at OSUCCC; and the Bone Marrow Transplant (BMT) registry, an internal database compiled of demographic and transplant-specific data. Area-level SES was measured by census tract-level (2008-2017) Yost indices (a composite of education-, income-, and occupation-related variables.)1, 2 Rural-urban status was measured by census tract-level 2010 Rural-Urban Commuting Area (RUCA) codes.3 Yost were categorized into quartiles where higher quartiles represented higher SES, and RUCA codes were grouped by metropolitan (Primary RUCA 1-3) v. non-metropolitan (Primary RUCA 4-10). Poisson regression models with robust variance were used to evaluate the associations between patient characteristics and receipt of transplant. Overall survival (OS) from diagnosis was analyzed and median OS was estimated using the Kaplan-Meier method. Cox proportional hazard models were used to estimate the hazard ratios of risk of death.

Conclusions:

In a large MM population, age, race, and area-level socioeconomic status impact both the receipt of transplant and overall survival following MM diagnosis. Area-level SES could be an important driver of MM survival independent of transplant access.

Trial information:

ASH 2022: Abstract #2266 (https://ash.confex.com/ash/2022/webprogram/Paper164653.html)

Authors:

Ashley E. Rosko, MD, Kaitlyn Dvorak, PhD, Qiuhong Zhao, MS, Electra Paskett, Samantha Jaglowski, MD, MPH, James L. Fisher, PhD, Jessica Krok-Schoen, Francesca Cottini, MD, Abdullah Khan, MBBS, MSc, Srinivas Devarakonda, MD, Naresh Bumma, MD, Elvira Umyarova, MD, Nidhi Sharma, PhD, Don M. Benson Jr., MD and Jesse Plascak, PhD