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Are Education Levels Predictive of Outcomes in Multiple Myeloma?

By: Julia Fiederlein
Posted: Wednesday, September 16, 2020

Juan Li, MD, PhD, of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China, and colleagues conducted a retrospective data analysis to investigate whether low education levels might be associated with poor survival outcomes in Chinese patients with multiple myeloma. The results of this recent multicenter study, which suggests low education levels may independently predict poor survival in this patient population, were published in BMC Cancer.

“Low- or middle-income countries have slower regulatory approval of drugs, fewer types of drugs available, and higher drug prices when adjusted for gross domestic product per capita; thus, the chances of effective treatment for these multiple myeloma patients are greatly reduced,” the investigators remarked. “The results of this study indicate that we can use the education level of newly diagnosed patients to evaluate the prognosis of these patients and to create more reasonable treatment plans.”

Between 2006 and 2019, a total of 773 patients with newly diagnosed multiple myeloma were enrolled. Of this study population, 69.2% had low education levels. These patients seemed to have elevated lactate dehydrogenase levels (23.1% vs. 13.0%; P = .003) and a higher proportion of international staging system stage III classification (32.5% vs. 23.7%; P = .014), compared with those who had high education levels. According to the investigators, more patients with high education levels underwent regular treatment (87.6% vs. 60.7%; P < .001) and transplantation (59.3% vs. 27.9%; P < .001) than those with low education levels.

The median duration of progression-free (67.5 vs. 30.6 months; P < .001) and overall (122.27 vs. 58.83 months; P < .001) survival appeared to be significantly longer in patients with high education levels than in those with low education levels. Based on the multivariable analysis, patients with a high education level also seemed to have significantly higher survival rates (hazard ratio = 0.32; P < .001) and lower relapse rates (hazard ratio = 0.50; P < .001).

Disclosure: The study authors reported no conflicts of interest.



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