SOCIOECONOMIC STATUS IS GLOBALLY A PROGNOSTIC FACTOR FOR OVERALL SURVIVAL OF MULTIPLE MYELOMA PATIENTS; SYNTHESIS OF STUDIES AND REVIEW OF THE LITERATURE SES as prognostic factor for myeloma survival
Main Article Content
Keywords
myeloma, socioeconomic status
Abstract
Socioeconomic status (SES) is reflecting differences in sociodemographic factors affecting cancer survivorship. Deprived, low SES populations has a higher prevalence of multiple myeloma and worst survival, a gap that widens over time.
Methods: We performed a meta-analysis of 16 studies (registries and cohorts) reporting survival data of myeloma patients according to SES. Ten studies reported Hazzard Ratio (HR) (95 % CI) and 16 studies reported p values. We combined the HR from 10 studies and by using the Mosteller-Bush formula we performed the synthesis of p values according to the area of the globe.
Results: A combination of HR from 10 studies including 85198 myeloma patients weighted to sample size of each study and adopting the hypothesis of random effect returned a combined HR: 1,26 (1,13-1,31) in favor of high SES patients.
USA: Synthesis of p values coming from 6 studies (n=89807 pts) by using the Mosteller and Bush formula extracted a p-value of <0.0001 favoring high SES patients
Oceania: Synthesis of p values in two cohorts from Australia and New Zealand (n= 10196 pts) returned a p-value of 0,022 favoring high SES patients
Europe: The synthesis of p values from UK and Greece studies (n=18533 pts) returned a p-value of <0,0001 favoring high SES patients
Asia: Synthesis of 2 studies from Asia (n=915 pts) returned a p-value of <0,0001 favoring high SES patients
Conclusions: Across the globe and widening over decades socioeconomic status remains a gap for equality in myeloma care
Downloads
Abstract 1415
PDF Downloads 545
HTML Downloads 153
References
2. Moreau P, San Miguel J, Sonneveld P et al. Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2017; 28: iv52-iv61.
3. Ailawadhi S, Azzouqa AG, Hodge D et al. Survival Trends in Young Patients With Multiple Myeloma: A Focus on Racial-Ethnic Minorities. Clin Lymphoma Myeloma Leuk 2019; 19: 619-623.
4. Sun T, Wang S, Sun H et al. Improved survival in multiple myeloma, with a diminishing racial gap and a widening socioeconomic status gap over three decades. Leuk Lymphoma 2018; 59: 49-58.
5. Costa LJ, Brill IK, Brown EE. Impact of marital status, insurance status, income, and race/ethnicity on the survival of younger patients diagnosed with multiple myeloma in the United States. Cancer 2016; 122: 3183-3190.
6. Hong S, Rybicki L, Abounader D et al. Association of Socioeconomic Status with Outcomes of Autologous Hematopoietic Cell Transplantation for Multiple Myeloma. Biol Blood Marrow Transplant 2016; 22: 1141-1144.
7. Savage D, Lindenbaum J, Van Ryzin J et al. Race, poverty, and survival in multiple myeloma. Cancer 1984; 54: 3085-3094.
8. Nandakumar A, Armstrong BK, de Klerk NH. Multiple myeloma in Western Australia: a case-control study in relation to occupation, father's occupation, socioeconomic status and country of birth. Int J Cancer 1986; 37: 223-226.
9. Harwood M, Dunn N, Moore J et al. Trends in myeloma relative survival in Queensland by treatment era, age, place of residence, and socioeconomic status. Leuk Lymphoma 2019; 1-7.
10. Renshaw C, Ketley N, Moller H, Davies EA. Trends in the incidence and survival of multiple myeloma in South East England 1985-2004. BMC Cancer 2010; 10: 74.
11. Rachet B, Mitry E, Shah A et al. Survival from multiple myeloma in England and Wales up to 2001. Br J Cancer 2008; 99 Suppl 1: S110-112.
12. Chan HSH, Milne RJ. Impact of age, sex, ethnicity, socio-economic deprivation and novel pharmaceuticals on the overall survival of patients with multiple myeloma in New Zealand. Br J Haematol 2019.
13. Nair MK, Varghese C, Krishnan E et al. Survival in multiple myeloma in Kerala. Natl Med J India 1993; 6: 7-10.
14. Abou-Jawde RM, Baz R, Walker E et al. The role of race, socioeconomic status, and distance traveled on the outcome of African-American patients with multiple myeloma. Haematologica 2006; 91: 1410-1413.
15. Intzes S, Symeonidou M, Zagoridis K et al. Socioeconomic Status Is an Independent Prognostic Factor for Overall Survival in Patients With Multiple Myeloma: Real-World Data From a Cohort of 223 Patients. Clin Lymphoma Myeloma Leuk 2020.
Article Sidebar
Article Details
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers. Authors will grant copyright of their articles to the Institute of Hematology, Catholic University, Rome . No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.