Title: African-Americans multiple myeloma patients undergoing upfront autologous stem cell

transplant have similar survival outcomes compared to whites: a propensity-score matched analysis

Authors: Romil Patel, BA1; Muzaffar Qazilbash, MD,1; Neeraj Saini, MD1;

Affiliations: 1 University of Texas M.D. Anderson Cancer Center, Depatment of Stem Cell
Transplantation & Cellular Therapy, 1515 Holcombe Blvd., Houston, TX - 77030

Corresponding Author: Patel, Romil, rdpatel1@mdanderson.org

Abstract:

Background: Limited access to novel therapies and autologous stem cell transplant (ASCT) has been
considered responsible for lower survival outcomes in African Americans (AA) affected by multiple
myeloma (MM). Patients receiving ASCT would have equal healthcare access and hence, will nullify the
impact of disparate health access on outcomes.

Methods: A total of 705 AA and whites MM patients who underwent auto-HCT at our institution from
2007 to 2015. We compared survival outcomes of AA versus whites who underwent upfront ASCT at our
center via propensity-matched analysis. We 1:1 matched 125/126 (99.25) black patients to white patients.
Clinical response, relapse, and progression were defined by the International Myeloma Working group
criteria.

Results: Patients in both groups were well matched for age at transplantation, ISS stage, serum
creatinine, response to induction therapy, induction, consolidation, and preparative regimens, and
maintenance therapy. The median follow-up time for the cohort was 70.8. The overall response rate after
auto-HCT was 119/125 and 123/125 patients in the AA and white group. The median progression free
survival (PFS) for the AA and the white groups were 44.6 and 51 months. The 4-year PFS rates in the AA
and the white groups were 48% and 51.2%, respectively. The 4-year overall survival (OS) rates in the AA
and the white groups were also similar at 78.5% and 80.9%.

Conclusions and Global Health Implications: On propensity score matching, AA multiple myeloma
patients had similar response rates, PFS, and OS to auto-HCT as white patients. Using transplantation in
AA should be a treatment priority to improve overall outcomes.

Key Words: multiple myeloma; stem cell transplantation; cellular therapy; propensity score matching;
chemotherapy