Understanding multiple myeloma in the Black community
Multiple myeloma is twice as common in the Black community compared to other ethnicities, and is twice as deadly in Black patients compared to white patients. Additionally, the conditions associated with the development of myeloma (including monoclonal gammopathy of undetermined significance, or MGUS) are seen frequently in Black patients.
Understand the Biological Differences in Black Multiple Myeloma Patients
Although myeloma treatment has advanced significantly in recent years, survival rates for Black myeloma patients have not kept pace with survival rates of other myeloma patient populations. The reasons for this are not known, but there are biological differences in Black patients compared to white patients. For example, in the MMRF CoMMpass Study, researchers discovered important differences in key cancer genes between Black and white myeloma patients. Black myeloma patients were shown to have a lower-risk genetic profile and thus would have been expected to achieve treatment results equal to—or even better than—those seen in other myeloma patient populations. But barriers to appropriate treatment and lack of awareness of the disease (on the part of both patients and community health care providers) contribute to treatment approaches inconsistent with current recommended practice.
To overcome these barriers and more effectively manage their disease, Black patients need to stay informed about these unique disease and management considerations.
Stay Informed About Diagnosis & Risk Factors in African Americans
Clinical aspects of myeloma also differ by race. For example, compared with whites, Black patients tend to have an earlier average age at diagnosis—by 5 to 10 years. Factors associated with high-risk myeloma, such as anemia (lower hemoglobin levels) and increased levels of lactate dehydrogenase (LDH) (which tends to increase as the disease progresses), have also been found to be more common in Black myeloma patients. A recent study also found higher incidences of hypercalcemia (a high calcium level in your blood due to bone degradation caused by myeloma cells), renal dysfunction, anemia, and dialysis (for treating kidney disease) in Black myeloma patients.
| Clinical Aspects of Multiple Myeloma in Black Patients | |
| More Common | Less Common |
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| Clinical Aspects of Multiple Myeloma in Black Patients | |
| More Common | |
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| Less Common | |
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Be Aware of Disparities in Detection & Care of Black Myeloma Patients
To improve the detection and management of multiple myeloma in Black patients, a greater recognition of the genetic, molecular, biological, and societal underpinnings of racial disparities on the part of both patients and health care providers is essential. There are disparities in the care of Black myeloma patients that need to be understood further and addressed. Issues relating to access to care and services, and lack of awareness of risk factors and optimal treatment strategies, contribute to care disparities. Black patients are 50% less likely to undergo stem cell transplantation, even though this treatment provides the same survival benefit for Black and white myeloma patients. Black patients are less likely than white patients to be treated with Velcade or Revlimid—despite the fact that these drugs have largely become the standard of care for myeloma patients.
| Disparities in Multiple Myeloma Care Among Black Patients | ||
| Time to Therapy Initiation | Utilization of Novel Therapeutic Agents | Utilization of Stem Cell Transplant |
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| Disparities in Multiple Myeloma Care Among Black Patients | ||
| Time to Therapy Initiation | ||
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| Utilization of Novel Therapeutic Agents | ||
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| Utilization of Stem Cell Transplant | ||
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Achieve Better Outcomes for African American Patients in Equal Access Systems
Studies have shown that when Black myeloma patients receive appropriate, timely care and treatment, they can achieve the same results as other myeloma patient populations. In such cases, response rate, survival, and total health care costs are similar across myeloma patient populations of different races.
| Treatment Outcomes for Black Patients with Multiple Myeloma in Equal-Opportunity Care and Evidence-Based Medicine |
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Despite disparities in incidence and outcomes of multiple myeloma among patients of different racial groups, the available evidence suggests that these disparities can be overcome. Ensuring equal access to appropriate therapeutic options is one essential step toward this goal. Increasing awareness of these disparities and their solutions—among patients and providers alike—is another.
A Conversation with Myeloma Nurse Practitioner Amy Pierre
Amy is an oncology nurse practitioner that specializes in multiple myeloma. In this interview, she explores known risk factors that are higher in African Americans compared to other populations, and comments on ways to break down existing barriers and ensure more equitable access to care for black patients.
Watch Now: Multiple Myeloma in African Americans Webinar
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