Study Finds Disparity in HCT Utilization for Hispanics with Multiple Myeloma

In this study of 28,450 patients who underwent autologous hematopoietic cell transplantation (HCT) for multiple myeloma between 2008 and 2014, researchers found the rate of transplant utilization in the U.S. was significantly lower for Hispanic patients compared to non-Hispanic whites.

Researchers used data from the CIBMTR® (Center for International Blood and Marrow Transplant Research®) with the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) database to calculate the incidence of multiple myeloma, and derive a stem cell transplantation utilization rate (STUR). The analysis included patients ages 18 to 75 years who underwent a first autologous HCT with reported 100 day follow-up data (n=24,102).

The STUR increased across all groups from 2008 to 2014 at an overall rate of 30.8%. Among Hispanics (range, 8.6-16.9%) the STUR rate almost doubled, while non-Hispanic blacks experienced a 70% increase (range, 12.2-20.5%) compared with higher rates for non-Hispanic whites (range, 22.6-37.8%).

Multivariate analysis of post-transplant outcomes showed that race and ethnicity had no impact on survival. Factors found to negatively affect survival included older age (61-75 years), a longer interval from diagnosis to transplant (>12 months) and pre-HCT adverse disease status.

Fewer patients >60 years underwent HCT among Hispanics (39%) and non-Hispanic blacks (42%) compared to non-Hispanic whites (56%). When compared to non-Hispanic white patients who underwent HCT, Hispanics undergoing transplant were younger, fitter and had advanced disease that responded to treatment.

In an accompanying editorial, Dr. Navneet Majhail discusses the ramifications of these results and notes that each patient has a unique disparity risk-profile “comprising social, cultural, economic and medical factors that are best addressed by interventions specific to their situation.”

Schriber JR, et al. Cancer