Unusual disease characteristics of multiple myeloma in eastern North Carolina.
Addepalli, S; Brigham, D; Liles, DK
Published in: Journal of Clinical Oncology
e19512 Background:Multiple Myeloma (MM) is a relatively common malignancy in Eastern NC, especially in African American population. There have been several advances in treatment of MM but it is unclear how well current therapies are being utilized and what barriers prevent this. Our goal was to identify any unique clinical and epidemiological features of this disease in our patient population as this may help us to improve outcomes. Methods: Demographics, clinical features, FISH/ Cytogenetic features, clinical outcomes of the patients enrolled on MMRF CoMMpass study at our institution were reviewed and analyzed to identify any unusual features in our dataset. Results:The median age at diagnosis of MM is 69 years. There was a higher proportion of younger patients in our dataset, 40% of our patients were < 60 years and 11% of patients were < 40 years which may point to environmental and genetic factors in this population and needs to be studied further. About 20% of patients with MM are reported to have Light Chain Myeloma (LCM) while 30% patients had LCM in our dataset. More patients had a higher stage of disease, ISS stage III at diagnosis, 72%.The benefits of Autologous Stem Cell Transplant (ASCT) in management of Multiple Myeloma is well established but only 22% of the patients had ASCT as part of their management. This appears to be secondary to multiple factors including comorbidities, socioeconomic factors such as financial concerns, difficulty with access to treatment and availability of care givers Conclusions:There is a disproportionately high proportion of younger patients with Multiple Myeloma in Eastern NC, especially with LCM. The environmental and genetic factors responsible for this need to be studied further. Many patients have a high tumor burden at diagnosis. Improvement in access to care, enhancement of provider education, collaboration with regional oncologists and study of novel drug combinations to achieve deeper and more durable responses may help improve outcomes for this treatable malignancy. "These data were generated as part of the Multiple Myeloma Research Foundation Personalized Medicine Initiatives (https://research.themmrf.org and www.themmrf.org)”.
