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Characteristics of long‐term survivors with multiple myeloma: A National Cancer Data Base analysis
Author(s) -
Hsieh Ronan W.,
Go Ronald S.,
Abeykoon Jithma P.,
Kapoor Prashant,
Kumar Shaji K.,
Gertz Morie A.,
Buadi Francis K.,
Leung Nelson,
Gonsalves Wilson I.,
Kourelis Taxiarchis V.,
Warsame Rahma M.,
Dispenzieri Angela,
Lacy Martha Q.,
Kyle Robert A.,
Rajkumar S. Vincent,
Paludo Jonas
Publication year - 2019
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.32357
Subject(s) - medicine , cancer registry , residence , population , multivariate analysis , cancer , univariate analysis , demography , logistic regression , multiple myeloma , gerontology , environmental health , sociology
Background There exist insufficient data characterizing patients with multiple myeloma (MM) who experienced prolonged survival. A population‐based analysis of long‐term survivors was conducted to investigate the roles of sociodemographic factors and upfront stem cell transplantation (SCT). Methods The National Cancer Data Base is a US cancer database of approximately 34 million patients from >1500 cancer centers. Patients with MM were identified using the International Classification of Diseases for Oncology (ICD‐O) code 9732 from January 2004 to December 2006 and were divided into 4 groups based on overall survival (OS). Sociodemographic characteristics, treatment facility, and use of SCT were recorded. The univariate and multivariate analyses were performed using multiple logistic regression and Pearson chi‐square tests. Results A total of 26,986 patients with MM were identified. The median OS was 2.74 years. The majority of patients were male (54%), white (77%), insured (93%) and otherwise healthy (78%), lived in a metropolitan area (82%), were of high income (66%) and educational (58%) levels, and received treatment at nonacademic facilities (63%). Upfront SCT was used in 10% of patients. One in 6 patients (16%) were long‐term survivors (group 4). When comparing group 4 (OS of ≥8.22 years) with the other groups (OS of <8.22 years), young age, female sex, high income and educational levels, residence in a rural area, insured status, no comorbidity, receipt of upfront SCT, and treatment at high‐volume facilities were associated with long‐term survival. Conclusions Key differences in sociodemographic characteristics, patient volume at treatment facilities, and upfront SCT were associated with long‐term survival. Improvements in health care access and health literacy, upfront SCT, and treatment at high‐volume facilities might prolong patient survival.