PMID- 33173025
OWN - NLM
STAT- MEDLINE
DCOM- 20210506
LR  - 20240330
IS  - 2044-5385 (Electronic)
IS  - 2044-5385 (Linking)
VI  - 10
IP  - 11
DP  - 2020 Nov 10
TI  - Race/ethnicity in systemic AL amyloidosis: perspectives on disease and outcome 
      disparities.
PG  - 118
LID - 10.1038/s41408-020-00385-0 [doi]
LID - 118
AB  - In marked contrast to multiple myeloma, racial/ethnic minorities are 
      underrepresented in publications of systemic light-chain (AL) amyloidosis. The 
      impact of race/ethnicity is therefore lacking in the narrative of this disease. 
      To address this gap, we compared disease characteristics, treatments, and 
      outcomes across racial/ethnic groups in a referred cohort of patients with AL 
      amyloidosis from 1990 to 2020. Among 2416 patients, 14% were minorities. 
      Non-Hispanic Blacks (NHBs) comprised 8% and had higher-risk sociodemographic 
      factors. Hispanics comprised 4% and presented with disproportionately more BU 
      stage IIIb cardiac involvement (27% vs. 4-17%). At onset, minority groups were 
      younger in age by 4-6 years. There was indication of more aggressive disease 
      phenotype among NHBs with higher prevalence of difference between involved and 
      uninvolved free light chains >180 mg/L (39% vs. 22-33%, P = 0.044). Receipt of 
      stem cell transplantation was 30% lower in Hispanics compared to non-Hispanic 
      White (NHWs) on account of sociodemographic and physiologic factors. Although the 
      age/sex-adjusted hazard for death among NHBs was 24% higher relative to NHWs 
      (P = 0.020), race/ethnicity itself did not impact survival after controlling for 
      disease severity and treatment variables. These findings highlight the 
      complexities of racial/ethnic disparities in AL amyloidosis. Directed efforts by 
      providers and advocacy groups are needed to expand access to testing and 
      effective treatments within underprivileged communities.
FAU - Staron, Andrew
AU  - Staron A
AUID- ORCID: 0000-0003-1638-4873
AD  - Amyloidosis Center, Boston University School of Medicine and Boston Medical 
      Center, 1 Boston Medical Center Place, Boston, MA, USA.
AD  - Section of Hematology and Oncology, Boston University School of Medicine and 
      Boston Medical Center, 1 Boston Medical Center Place, Boston, MA, USA.
FAU - Connors, Lawreen H
AU  - Connors LH
AUID- ORCID: 0000-0002-4672-4296
AD  - Amyloidosis Center, Boston University School of Medicine and Boston Medical 
      Center, 1 Boston Medical Center Place, Boston, MA, USA.
AD  - Department of Pathology and Laboratory Medicine, Boston University School of 
      Medicine and Boston Medical Center, 1 Boston Medical Center Place, Boston, MA, 
      USA.
FAU - Zheng, Luke
AU  - Zheng L
AUID- ORCID: 0000-0001-8468-4590
AD  - Department of Biostatistics, Boston University School of Public Health, 715 
      Albany Street, Boston, MA, USA.
FAU - Doros, Gheorghe
AU  - Doros G
AUID- ORCID: 0000-0001-5524-4721
AD  - Amyloidosis Center, Boston University School of Medicine and Boston Medical 
      Center, 1 Boston Medical Center Place, Boston, MA, USA.
AD  - Department of Biostatistics, Boston University School of Public Health, 715 
      Albany Street, Boston, MA, USA.
FAU - Sanchorawala, Vaishali
AU  - Sanchorawala V
AUID- ORCID: 0000-0002-6307-2445
AD  - Amyloidosis Center, Boston University School of Medicine and Boston Medical 
      Center, 1 Boston Medical Center Place, Boston, MA, USA. 
      Vaishali.Sanchorawala@bmc.org.
AD  - Section of Hematology and Oncology, Boston University School of Medicine and 
      Boston Medical Center, 1 Boston Medical Center Place, Boston, MA, USA. 
      Vaishali.Sanchorawala@bmc.org.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20201110
PL  - United States
TA  - Blood Cancer J
JT  - Blood cancer journal
JID - 101568469
SB  - IM
MH  - Aged
MH  - Disease-Free Survival
MH  - *Ethnicity
MH  - Female
MH  - Humans
MH  - Immunoglobulin Light-chain Amyloidosis/*ethnology/*mortality
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Socioeconomic Factors
MH  - Survival Rate
PMC - PMC7655813
COIS- The authors declare that they have no conflict of interest.
EDAT- 2020/11/12 06:00
MHDA- 2021/05/07 06:00
PMCR- 2020/11/10
CRDT- 2020/11/11 05:51
PHST- 2020/07/07 00:00 [received]
PHST- 2020/10/23 00:00 [accepted]
PHST- 2020/10/01 00:00 [revised]
PHST- 2020/11/11 05:51 [entrez]
PHST- 2020/11/12 06:00 [pubmed]
PHST- 2021/05/07 06:00 [medline]
PHST- 2020/11/10 00:00 [pmc-release]
AID - 10.1038/s41408-020-00385-0 [pii]
AID - 385 [pii]
AID - 10.1038/s41408-020-00385-0 [doi]
PST - epublish
SO  - Blood Cancer J. 2020 Nov 10;10(11):118. doi: 10.1038/s41408-020-00385-0.