Talha Badar1, Parameswaran Hari2, Omar Dávila2, Raphael Fraser2,3, Baldeep Wirk4, Binod Dhakal5, Cesar O Freytes6, Cesar Rodriguez Valdes7, Cindy Lee8, David H Vesole9, Ehsan Malek10, Gerhard C Hildebrandt11, Heather Landau12, Hemant S Murthy13, Hillard M Lazarus14, Jesus G Berdeja15, Kenneth R Meehan16, Melhem Solh17, Miguel Angel Diaz18, Mohamed A Kharfan-Dabaja13, Natalie S Callander19, Nosha Farhadfar20, Qaiser Bashir21, Rammurti T Kamble22, Ravi Vij23, Reinhold Munker11, Robert A Kyle24, Saurabh Chhabra1,2, Shahrukh Hashmi25,26, Siddhartha Ganguly27, Sundar Jagannath28, Taiga Nishihori29, Yago Nieto21, Shaji Kumar24, Nina Shah21, Anita D'Souza2. 1. Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. 2. Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. 3. Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin. 4. Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, Pennsylvania. 5. Blood and Marrow Transplantation and Cellular Therapy, Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin. 6. Texas Transplant Institute, San Antonio, Texas. 7. Wake Forest Baptist Health, Winston-Salem, North Carolina. 8. Royal Adelaide Hospital, Adelaide, South Australia, Australia. 9. John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey. 10. Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio. 11. Markey Cancer Center, University of Kentucky, Lexington, Kentucky. 12. Bone Marrow Transplant Service, Division of Hematology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. 13. Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Mayo Clinic Florida, Jacksonville, Florida. 14. University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio. 15. Sarah Cannon Research Institute, Nashville, Tennessee. 16. Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire. 17. Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, Georgia. 18. Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain. 19. University of Wisconsin Carbone Cancer Center, Madison, Wisconsin. 20. Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, Florida. 21. Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas. 22. Center for Cell and Gene Therapy, Division of Hematology and Oncology, Baylor College of Medicine, Houston, Texas. 23. Division of Hematology and Oncology, Washington University School of Medicine, St. Louis, Missouri. 24. Mayo Clinic Rochester, Rochester, Minnesota. 25. Department of Internal Medicine, Mayo Clinic, Rochester, New York. 26. Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. 27. Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas. 28. Mount Sinai Medical Center, New York, New York. 29. Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida.
Abstract
BACKGROUND: Multiple myeloma (MM) with the translocation t(11;14) may have inferior outcomes in comparison with other standard-risk MM, and it has been suggested to portend a worse prognosis in African Americans in comparison with Whites. This study used the Center for International Blood and Marrow Transplant Research (CIBMTR) database to examine the impact of t(11;14) on the clinical outcomes of patients with MM of African American and White descent. METHODS: This study evaluated 3538 patients who underwent autologous hematopoietic cell transplantation (autoHCT) for MM from 2008 to 2016 and were reported to the CIBMTR. Patients were analyzed in 4 groups: African Americans with t(11;14) (n = 117), African Americans without t(11;14) (n = 968), Whites with t(11;14) (n = 266), and Whites without t(11;14) (n = 2187). RESULTS: African Americans with t(11;14) were younger, had lower Karnofsky scores, and had more advanced stage MM with a higher Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI). Fewer African Americans with t(11;14) (21%) had a coexistent high-risk marker in comparison with Whites with t(11;14) (27%). In a multivariate analysis, race and t(11;14) had no association with progression-free survival. However, overall survival was superior among African Americans with t(11;14) in comparison with Whites with t(11;14) (hazard ratio, 0.53; 95% confidence interval, 0.30-0.93; P = .03). Survival was also associated with female sex, stage, time from diagnosis to transplant, a low HCT-CI, and receipt of maintenance. CONCLUSIONS: Race may have a differential impact on the survival of patients with t(11;14) MM who undergo autoHCT and needs to be further studied.
BACKGROUND:Multiple myeloma (MM) with the translocation t(11;14) may have inferior outcomes in comparison with other standard-risk MM, and it has been suggested to portend a worse prognosis in African Americans in comparison with Whites. This study used the Center for International Blood and Marrow Transplant Research (CIBMTR) database to examine the impact of t(11;14) on the clinical outcomes of patients with MM of African American and White descent. METHODS: This study evaluated 3538 patients who underwent autologous hematopoietic cell transplantation (autoHCT) for MM from 2008 to 2016 and were reported to the CIBMTR. Patients were analyzed in 4 groups: African Americans with t(11;14) (n = 117), African Americans without t(11;14) (n = 968), Whites with t(11;14) (n = 266), and Whites without t(11;14) (n = 2187). RESULTS: African Americans with t(11;14) were younger, had lower Karnofsky scores, and had more advanced stage MM with a higher Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI). Fewer African Americans with t(11;14) (21%) had a coexistent high-risk marker in comparison with Whites with t(11;14) (27%). In a multivariate analysis, race and t(11;14) had no association with progression-free survival. However, overall survival was superior among African Americans with t(11;14) in comparison with Whites with t(11;14) (hazard ratio, 0.53; 95% confidence interval, 0.30-0.93; P = .03). Survival was also associated with female sex, stage, time from diagnosis to transplant, a low HCT-CI, and receipt of maintenance. CONCLUSIONS: Race may have a differential impact on the survival of patients with t(11;14) MM who undergo autoHCT and needs to be further studied.
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