Myeloma and race: A review of the literature

@article{Benjamin2004MyelomaAR,
  title={Myeloma and race: A review of the literature},
  author={Michael Benjamin and Sreekanth P. Reddy and Otis W. Brawley},
  journal={Cancer and Metastasis Reviews},
  year={2004},
  volume={22},
  pages={87-93}
}
Multiple myeloma is an uncommon disease, with approximately 12,000 cases per year diagnosed in America. Blacks have had at least double the risk of being diagnosed with myeloma, and have had twice the mortality rate from the disease compared to whites 1. Research of the origins of this difference has yielded both insight and controversy. Obesity is likely a risk factor for myeloma, in both blacks and whites. Obesity is more prevalent in the black population, and this may help explain some of… 

Disparities in the prevalence, pathogenesis and progression of monoclonal gammopathy of undetermined significance and multiple myeloma between blacks and whites

TLDR
The literature on racial disparity in the prevalence, pathogenesis and progression of MGUS and multiple myeloma between blacks and whites is reviewed and it is suggested that the risk may be lower in certain racial and ethnic groups, notably persons from Japan and Mexico.

Dissecting racial disparities in multiple myeloma

TLDR
Innovative and multidisciplinary approaches are urgently needed to enhance the understanding of disparities that exist at each stage of the MM disease continuum and facilitate their elimination.

Racial disparities in incidence and outcome in multiple myeloma: a population-based study.

TLDR
A younger age of onset among blacks; better survival in blacks 1973-2005; and significant survival improvement among whites over time, with smaller, nonsignificant change seen among blacks are found, possibly due to unequal access to and/or disparate responsiveness to novel therapies.

Patterns of monoclonal gammopathy of undetermined significance and multiple myeloma in various ethnic/racial groups: support for genetic factors in pathogenesis

TLDR
Interestingly, prevalence and incidence patterns for MGUS and MM show striking disparity patterns across ethnic/racial groups, most notably the two- to threefold increase in both these disorders in African Americans compared with Caucasians.

Racial differences in treatment and outcomes in multiple myeloma: a multiple myeloma research foundation analysis

TLDR
Multivariate analysis in the Black subset found that only lack of ASCT was significantly associated with inferior OS, emphasizing the need for race-specific risk prognostication schema to guide optimal MM therapy.

The knowns and unknowns of disparities, biology, and clinical outcomes in Hispanic and Latinx multiple myeloma patients in the U.S.

TLDR
An overview of the current state of knowledge on racial and ethnic differences in the epidemiology, biology, and clinical outcomes of patients with MM, with a special emphasis on Hispanic and Latinx individuals is provided.

Impact of age, race and decade of treatment on overall survival in a critical population analysis of 40,000 multiple myeloma patients

TLDR
As the largest population analysis to date, this study reveals a statistically significant improvement in OS for patients who were treated in more recent decades, even before the availability of novel agents.

The impact of race on outcomes of autologous transplantation in patients with multiple myeloma

TLDR
In a cohort of myeloma patients who received autologous transplantation in an equal access health care system, there was comparable survival between African‐Americans and Caucasians, suggesting that the historical increased mortality for African-Americans may be due to inequalities in access to care.

Energy Balance and Multiple Myeloma in African Americans

TLDR
Obesity—a risk factor for MM that is more prevalent in African Americans than in whites— has been hypothesized to contribute to racial disparities in this disease.
...

References

SHOWING 1-10 OF 23 REFERENCES

Multiple myeloma among blacks and Whites in the United States: the role of chronic antigenic stimulation

TLDR
The findings do not support a causal relationship between CAS and MM, nor do they explain the higher incidence among Blacks, but there was a suggestion of increased risk among Blacks with an increased exposure to anaphylatic conditions.

Multiple myeloma among Blacks and Whites in the United States: role of cigarettes and alcoholic beverages

TLDR
Previous studies indicating that smoking and drinking are not relatedcausally to the risk of multiple myeloma, and thus cannot account for theracial disparity in incidence rates are supported.

Diet and nutrition as risk factors for multiple myeloma among blacks and whites in the United States

TLDR
The greater use of vitamin C supplements by whites and the higher frequency of obesity among blacks may explain part of the higher incidence of multiple myeloma among blacks compared to whites in the United States.

HLA and multiple myeloma among black and white men: evidence of a genetic association.

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    Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
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TLDR
It is suggested that the Cw2 allele enhances the risk of myeloma in blacks and whites but do not explain the higher incidence of this cancer among blacks, and that undefined DQ antigens may play an etiological role.

Obesity and multiple myeloma

TLDR
Findings suggest that body build or nutritional status may be involved in the development of MM by mechanisms that are presently unknown if increased weight is a causal factor, weight loss occurs later after the disease process begins.

Effects of socioeconomic and clinical factors on survival in multiple myeloma.

TLDR
It was recently reported that low socioeconomic status (SES) in multiple myeloma patients is associated with a poorer prognosis, and data from interviews of 153 MM patients seen at Duke University Medical Center over a 6-year period did not confirm this finding.

Socioeconomic status and multiple myeloma among US blacks and whites.

TLDR
The results indicate that the measured SES-related factors account for a substantial amount of the Black-White differential in multiple myeloma incidence.

Evaluation of race as a prognostic factor in multiple myeloma. An ancillary of Southwest Oncology Group Study 8229.

TLDR
Survival for black myeloma patients was similar to that for white patients, both overall and adjusted for prognostic factors such as stage, and observed differences in mortality between blacks and whites cannot be attributed to differences in survival after diagnosis.

Socioeconomic Status and the Incidence of Multiple Myeloma

TLDR
Risk of multiple myeloma was inversely associated with socioeconomic status scores in both men and women and the occupation-based scores were stronger predictors of risk than years of education.

Multiple myeloma in the Afro-Caribbean population of Curaçao.

TLDR
The incidence rate of multiple myeloma in the Afro-Caribbean population of Curaçao is one of the lowest reported in black populations; however, the presentation and course of MM follow the pattern seen in most other countries.