Myeloma Is Complicated

Tiffany Williams |

Since attending ASH in 2016,  I’ve been interested in better understanding the ongoing plight to improve outcomes and assure that all patient benefit equally from advances in treatment. Each year, researchers address disparities impacting care of multiple myeloma patients. In addition to numerous scientific oral presentations, I had the opportunity to attend an interesting paper and poster presentation specific to disparities this year:

Outcomes of Black Patients with Multiple Myeloma in the Veterans Health Administration (Martin W. Schoen, MD,MPH).

In this VA study, black patients were found to have better outcomes compared to the general population. There wasn’t any evidence of disparities in treatment. It was also interesting that black patients were more likely to have more comorbidities, yet better survival despite this. The VA is an integrated health care system where access to treatment is less of issue, likely contributing to the lack of disparity found. Schoen shared that these racial differences support different disease biology. I don’t believe we fully understand racial differences in disease biology, and I’m sure we’ll continue to see more research in this area.

There was also poster presentation from the same Veterans Health Administration study (above) that I found interesting.

With Equal Access and Utilization of Resources, Younger African American Patients Have Superior Survival Compared to Caucasian Patients Diagnosed with Multiple Myeloma at the Veterans Affairs Hospitals (Natanael Fillmore, PhD).

No racial disparity in transplantation or therapy at induction was found in patients at the VA (82.5% of African American patients and 81.5% Caucasian patients). I find this very interesting, given findings from previous studies which contradict these findings. It really piques my interest in understanding the VA system and healthcare model. They also found that younger African American patients may have improved overall survival. The median survival among patients in their 40s was (7.5 years), 50s (5.9 years), 60s (5.2 years), 70s (3.5 years) and 80s (2.6 years). Their findings suggested a genetic difference for better outcomes in black patients.

There appears to be a safe guard against disparities among multiple myeloma patients within the VA system that should be explored further. If myeloma patients in the VA system do not share disparities similar to the general population, perhaps we should replicate the VA’s model. I know! If only it were that easy.…Myeloma is complicated and so are health disparities.

My experiences over the years as a support group leader has been that most leaders are experiencing similar challenges, looking for ways to diversity group participation and ensure that we all live well with myeloma. Much like the healthcare system, we have to better understand barrier to participation. I look forward to seeing future research exploring barriers and genetic differences in myeloma patients.

Wishing you Hope,

Tiffany

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