Impact of demographic and socioeconomic factors on survival outcomes in patients with Waldenstrom macroglobulinemia: A SEER database analysis from 2000-2021.

Abstract

e19046 Background: Waldenstrom Macroglobulinemia (WM) is a rare, indolent B-cell malignancy characterized by the overproduction of IgM monoclonal proteins. Various clinical and laboratory parameters have been identified that confer poor prognosis in patients with WM. However, the impact of demographic and socioeconomic factors on patient survival has not been fully elucidated. In this study, we sought to evaluate the effects of race, sex, geography, and income on survival among patients diagnosed with WM, utilizing data from the Surveillance, Epidemiology, and End Results (SEER) database. Methods: We extracted data from the SEER registry for patients diagnosed with WM between 2000 and 2021. The primary outcome was cause-specific survival. Exclusion criteria included missing or unknown data on race, income, or location, or patients outside the study period. Kaplan-Meier survival curves were employed to estimate 5-year survival rates. Differences between groups were assessed using the log-rank test. Hazard ratios (HR) were calculated to compare 5-year overall survival (OS) across various demographic and socioeconomic groups. Results: A total of 13,121 patients with WM were included in the analysis. 7,769 (59.2%) patients were males. The racial distribution was as follows: White (83.7%), Black (4.4%), Non-Hispanic Asian/Pacific Islander (5.4%), Hispanic (6.2%), and Alaskan-Native/American Indian (0.3%). 82.0% patients resided in urban areas, and 77.1% of the patients reported household income > $70,000/year. Males had a significantly inferior 5-year OS compared to females, with a HR of 1.2 (95% CI: 1.1-1.2, p<0.001). Taking White patients as reference, there was no difference in 5-year OS across different racial groups (see Table 1). Patients residing in rural areas had worse 5-year OS as compared to those in urban areas, with a HR of 1.1 (95% CI 1.1-1.2, p<0.001). Additionally, patients with household incomes below $70,000/year had worse 5-year OS compared to those with incomes above $70,000/year, with a HR of 1.2 (95% CI 1.1-1.2, p<0.001). Conclusions: This study demonstrates that male sex, rural residence, and lower household income are associated with worse survival outcomes in patients with WM. These findings highlight the importance of considering demographic and socioeconomic factors in the management and care of WM patients Demographic and socioeconomic factors impacting survival outcomes in WM patients. Factor Group HR (95% CI) P-value Sex Male 1.2 (1.1-1.2) <0.001 Female - Race White - - Black 1.0 (0.9-1.2) 0.565 Non-Hispanic Asian/PI 1.0 (0.9-1.1) 0.823 Hispanic 1.1 (0.9-1.2) 0.224 Alaskan-Native/Indian 0.9 (0.6-1.5) 0.723 Geography Rural 1.1 (1.1-1.2) <0.001 Urban - Annual household income Below $70,000 1.2 (1.1-1.2) <0.001 Above $70,000 -