To compare overall survival among Black and White patients newly diagnosed with multiple myeloma in a civilian integrated health system during 2017–2023.
Approach:
Design and cohort: Retrospective cohort study of 1,209 adults with newly diagnosed multiple myeloma treated at Cleveland Clinic; survival follow-up continued through April 30, 2026.
Analysis: Estimated 5-year overall survival using Kaplan–Meier methods and overlap weighting to balance measured baseline characteristics. Multivariable Cox regression assessed mortality by race. A sensitivity analysis was limited to patients who received at least one medication commonly used for multiple myeloma induction therapy.
Key Findings:
Triplet or quadruplet therapy within the first year was received by 58.2% of Black patients and 55.9% of White patients.
After overlap weighting, estimated 5-year overall survival was 59.8% (95% CI, 52.9–67.6%) for Black patients and 58.3% (95% CI, 53.2–63.8%) for White patients.
Adjusted mortality hazard for Black versus White patients was 0.73 (95% CI, 0.55–0.97); the sensitivity analysis estimate was 0.74 (95% CI, 0.55–1.00).
Interpretation:
In this cohort, Black patients had similar overlap-weighted 5-year overall survival to White patients and a lower adjusted hazard of death. The authors examined these outcomes in the context of previously reported similar use of triplet or quadruplet therapy across racial groups.
Limitations:
The study was conducted within one integrated health system in Ohio and Florida, which may limit generalizability.
Stem cell transplantation occurred less often in Black patients; the provided context ends before the full limitations are reported.
