ASH 2025 | Impact of race and social deprivation on clinical outcomes in newly diagnosed multiple myeloma

We know that multiple myeloma is two to three times more common in black individuals as compared to white. But we don’t really fully understand the impact of race and ethnicity on outcomes with patients with multiple myeloma. I think one of the reasons behind that is some of the socioeconomic barriers as well as difficulties with access to effective therapies. And to investigate the impact of race, ethnicity, and social deprivation on outcomes with patients who need to be diagnosed with multiple myeloma, we actually conducted a retrospective analysis utilizing the ASH research collaborative data hub registry. It’s a registry with 11 centers that are involved and have more than 10,000 patient data. And for this particular study, we actually identified zip code as the determinant of social deprivation using a social deprivation index score. This score is, in fact, a composite score of the levels of social deprivation within a community and takes into account multiple socioeconomic factors, including education, transportation, income, and medical status, and helps us identify areas that may actually be at the risk of social deprivation. 

Looking at our data set, we had about 2,000 patients who received frontline therapy for multiple myeloma from 2015 to 2025. We had data available on the frontline therapies for these patients. We had data available on the efficacy outcomes as well. And what we learned within this patient population is that 70% of the patients were white, 30% were black. And amongst the black patients, the myeloma was diagnosed at an earlier age. The chances of going towards a transplant were actually lower within the first 12 months, as well as a longer time from frontline therapy to transplant for these patients. More importantly, there was a higher social deprivation index score, which means more social deprivation within the black patients as compared to the white ones. 

When you look at efficacy outcomes, we found that response rates, progression-free survival, and overall survival are actually not any different between the black and the white individuals. Having said that, when we performed a multivariable analysis, adjusting for all significant predictors of outcomes, including the patient’s disease stage, cytogenetic risk profile, as well as the kind of regimen that they received, we actually learned that social deprivation index scores were highly predictive in the multivariable model of inferior outcomes. So what we concluded from this particular study is that it’s not just the race alone, but in fact the social deprivation within a particular race or ethnicity that determines inferior outcomes in these patients. And we believe that any studies that will be performed in the future should take into account not just the race or ethnicity of the patient population they’re looking at, but also in fact the levels of social deprivation to determine the impact on the outcomes.

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