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Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Posted: Monday, January 17, 2022
Clinical disparities in patients with multiple myeloma appear to be influenced by age at diagnosis, tumor mutations, and clonal hematopoiesis. Nancy Gillis, PharmD, PhD, of H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, and colleagues proposed there was no statistically significant difference in progression-free survival by race and/or ethnicity in a diverse group of patients treated for myeloma. These findings were presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 402).
The study included patients diagnosed with multiple myeloma, tumor cells purified from bone marrow aspirations by CD1138 affinity chromatography. DNA was isolated from tumor cells and whole blood for each patient, and whole-exome sequencing data were generated. Tumor somatic mutations were characterized using paired tumor-normal (blood) whole-exome sequencing. Clonal hematopoiesis was classified based on blood-derived somatic mutations, using paired tumors and reference populations as germline comparators. The study measured overall and progression-free survival.
Of the 496 patients enrolled in the study, 80% were non-Hispanic White, 10% were non-Hispanic Black, and 9% were Hispanic. Non-Black and Hispanic patients with multiple myeloma had a younger median age at diagnosis (57 and 53 years, respectively) compared with non-Hispanic White patients (63 years). Non-Hispanic Black patients had a longer time to hematopoietic cell transplantation (376 days) than non-Hispanic White or Hispanic patients (248 and 270 days, respectively). According to the investigators, there was no statistical difference in treatment categories, overall survival, or progression-free survival by race/ethnicity.
The most mutated genes in multiple myeloma were KRAS (24%), NRAS (17%), TP53 (11%), DIS3 (9%), and BRAF (9%). Genes with significantly higher tumor mutation rates in non-Hispanic Black compared with non-Hispanic White patients were SP140 (12% vs. 4%, respectively), AUTS2 (8% vs. 2%, respectively), and SETD2 (6% vs. 1%, respectively). IRF4 was most commonly mutated in Hispanic patients (11% vs. 3% in non-Hispanic White and 0% in non-Hispanic Black patients).
Disclosure: For full disclosures of the study authors, visit ash.confex.com.
2021 ASH Annual Meeting & Exposition
