Health disparities experienced by Black and Hispanic Americans with multiple myeloma in the United States: a population-based study

Abstract

Hispanics and non-Hispanic (NH)-Blacks continue to face numerous health disparities related to multiple myeloma (MM). We aimed to analyze trends of MM-related hospitalizations and incidence of in-hospital mortality with a 10-year cross-sectional analysis of inpatient hospitalizations. The prevalence of MM-related hospitalizations was higher in NH-Blacks compared to NH-Whites (476.0 vs. 305.6 per 100,000 hospitalizations, p < .001). MM-related in-hospital mortality was higher in Hispanics compared to NH-Whites and NH-Blacks (6.2 vs. 5.3%, p < .001). Using average annual percent change (AAPC), we found a statistically significant decline of in-hospital mortality among all MM patients except NH-Blacks (AAPC: −2.2, 95% confidence interval (CI) −4.7, 0.4, p = .47), who had the highest inpatient mortality in recent years. Multivariate analysis showed that NH-Blacks received fewer transplants, more blood product transfusions, fewer palliative care consults, less inpatient chemotherapy, and utilized more intensive care. Disparities in MM care for NH-Blacks and Hispanics continue to persist despite recent advancements in MM therapy.

Keywords:

• Multiple myeloma
• Black Americans
• African Americans
• Hispanics
• health disparities
• disparities

Acknowledgements

The authors thank Catherine A. Gillespie, senior editor, Center for Cell and Gene Therapy, Baylor College of Medicine, Texas Children’s Hospital and Houston Methodist Hospital, Houston, Texas, for help with the scientific editing of the paper.

Disclosure statement

PL serves on the advisory board for Karypharm and received research support from Allovir and Marker Therapeutics. LH serves on the advisory board for Incyte. Carlos A. Ramos has served on advisory boards for Novartis and Celgene, and received research support from Tessa Therapeutics and Kuur Therapeutics, outside of the submitted work. HEH is a co-founder with equity in Allovir and Marker Therapeutics, has served on advisory boards for Novartis, Gilead, Tessa Therapeutics, PACT Pharma and Mesoblast and received research support from Tessa Therapeutics and Kuur Therapeutics. SZU reports grants and personal fees from Amgen, personal fees from Abbvie, grants from BMS, grants and personal fees from Celgene, personal fees from MundiPharma, grants from Pharmacyclics, grants and personal fees from Sanofi, grants and personal fees from GSK, grants and personal fees from Seattle Genetics, grants and personal fees from Janssen, grants and personal fees from Takeda, grants and personal fees from SkylineDX, grants and personal fees from Merck, outside the submitted work. Portions of this study will be presented at the American Society of Clinical Oncology Annual Meeting in 2021 and Baylor College of Medicine's Fourth Annual 2021 Center of Excellence in Health Equity, Training and Research (COE) Summer Research Summit.

Additional information

Funding

Samer Al Hadidi reports salary support by the National Heart, Lung, and Blood Institute Grant No. 5T32HL092332-18 and Grant Number 1 D34HP31024-01-00 from the Health Resources and Services Administration (HRSA) for the project titled Baylor College of Medicine (BCM) Center of Excellence in Health Equity, Training & Research. Premal Lulla received research support from the Cancer Prevention and Research Institute of Texas (CPRIT) Early Career Clinical Investigator Award. Helen Heslop receives research support from National Cancer Institute Grants No. P50CA126752, the Stand Up To Cancer (SU2C)/American Association for Cancer Research (AACR) 604817 Meg Vosburg T-Cell Lymphoma Dream Team, and the Leukemia and Lymphoma Society. SU2C is a program of the Entertainment Industry Foundation administered by the AACR. Saad Z. Usmani is supported by the Leukemia Lymphoma Society Scholar in Clinical Research Grant, Carolinas Myeloma Research Fund, and the William Britton Family Fund.