The role of race, socioeconomic status, and distance traveled on the outcome of African-American patients with multiple myeloma.

Myeloma Research Program, Cleveland Clinic, Cleveland, Ohio, USA.
Haematologica (Impact Factor: 5.87). 11/2006; 91(10):1410-3.
Source: PubMed

ABSTRACT The incidence and mortality of multiple myeloma (MM) in African-Americans is double that in whites. We questioned whether race, socioeconomic status, and distance traveled affect overall survival. In a retrospective review of the records of 292 patients with MM. We found that the median age was 60 years and 38 patients were African-Americans. The mean distance traveled was 67.7 miles. The median overall survival was similar in African-Americans and whites. Race, distance traveled and socioeconomic status were not independent prognostic factors for overall survival. In conclusion, socioeconomic status, distance traveled and race did not affect outcomes of MM patients treated at a specialized myeloma center.

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    ABSTRACT: 1p.1411 Simultaneous analysis of correlated variables potentially over-controlled for the underlying mechanism and thus reduced the ability to observe sep- arate effects of race, SES, and distance traveled. It would have been more congruent with the study objectives to stratify by race and separately investigate SES or distance traveled. The authors also over-controlled for correlated clinical prognostic factors and omitted other important potential confounders. MM stage was defined by the Southwest Oncology Group (SWOG) staging system and incorporated into the model as a covariate along with β2 microglobulin (β2M) and albumin. 1p.1411 However, SWOG already incorporates β2M and albumin as part of its stag- ing criteria. 3 The results suggest over-controlling because stage, β2M, and albumin were not reported as predictors of MM survival, 1p.1411 despite ample evidence to the con- trary. 3-5 Furthermore, important prognostic factors such as C-reactive protein (CRP) were not addressed, despite evidence that concurrently elevated CRP and β2M are markers of poor prognosis in MM. 4 Elevated lactate dehydrogenase (LDH) is another important marker of poor survival for MM patients that was not incorporat- ed. 4 Inclusion of LDH could have partially accounted for lack of cytogenetic data.
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