Clinical characteristics and outcomes of multiple myeloma in Asian Indian and Pakistani Americans (AIPA).

Abstract

e19558 Background: Multiple myeloma (MM) is a hematologic malignancy associated with significant morbidity and mortality, including complications like osteolytic lesions and chronic kidney disease (CKD). While global studies have explored MM's clinical characteristics, data on its prevalence and outcomes in Asian Indian and Pakistani Americans (AIPA) is limited. As one of the fastest-growing ethnic groups in the U.S., understanding MM's clinical features and survival outcomes in this population is essential. This study aims to compare the clinical characteristics, treatment patterns, and survival outcomes of MM in AIPA patients with those of non-Hispanic White (NHW) patients, offering insights into MM disparities within the U.S. healthcare system. Methods: Data on MM patients aged ≥18 years diagnosed between 1990 and 2021 were obtained from the SEER database. Baseline characteristics, including age, sex, income, rural/urban residence, treatment, and survival, were analyzed. Univariate survival analysis was conducted using Kaplan-Meier plots with log-rank tests. Cox proportional hazard regression models were used for multivariate survival analysis. Results: A total of 25,143 MM cases were analyzed, including 24,925 NHW and 218 AIPA patients. AIPA patients were younger at diagnosis than NHW patients (mean age: 65.4 ± 12.5 years vs. 69.8 ± 11.7 years; p < 0.001). The AIPA cohort had a higher proportion of individuals with higher income levels (≥90,000: 65.6% vs. 36.3%) and predominantly resided in metropolitan areas (99.5% vs. 82.2%). AIPA patients were slightly more likely to receive chemotherapy than NHW patients (66.1% vs. 59.6%). The prevalence of distant metastasis at diagnosis was similar between the groups (89.9% AIPA vs. 85.4% NHW). Survival analysis revealed that AIPA patients had better 3-year survival rates (68.9%, 95% CI: 61.2-75.3) compared to NHW patients (58.7%, 95% CI: 57.9-59.3). The 6-year survival rates were also higher among AIPA (55.4%, 95% CI: 46.9-63.3) than NHW (43.9%, 95% CI: 43.2-44.7). After adjustment for covariates, AIPA demonstrated significantly improved overall survival compared to NHW (HR = 0.72, CI = 0.59-0.88). Conclusions: This study highlights that patients with AIPA multiple myeloma (MM) are diagnosed at a younger age and demonstrate more favorable survival outcomes compared to NHW patients. These findings suggest potential differences in underlying biology, healthcare access, or socioeconomic factors. However, further investigation is required to fully understand the mechanisms driving these differences, that may include identifying specific genetic or molecular factors, healthcare utilization patterns, and how socioeconomic determinants influence treatment access and outcomes. Addressing these disparities could lead to more personalized and equitable treatment strategies, ultimately improving MM outcomes across diverse populations.