Cases of SCC-Related Hospitalizations Increasing Among Patients With Multiple Myeloma

Hospitalizations due to spinal cord compression (SCC) are increasing among patients with multiple myeloma (MM), explained the researchers of a new study published in Clinical Hematology International, which also identified ethnic groups at higher risk of hospitalization from the condition.

MM has previously been reported as the third most prevalent underlying cancer diagnosis associated with hospitalization for SCC, a medical emergency that can cause pain and potential irreversible loss of neurologic function. With the cancer being more common in non-Hispanic Black patients and with these patients and Hispanic patients being more likely to face health-related disparities, researchers of the current study analyzed racial/ethnic differences in hospitalizations for SCC among patients with MM.

“Our study is the first to report on racial/ethnic differences of the rates of SCC in hospitalized MM patients using a representative large national sample,” described the researchers. “MM is a heterogeneous disease, and such clinical difference can be related to variability in the molecular subtype of MM and/or other clinical features of MM. Future analysis from the [University of Arkansas for Medical Sciences] MM database is being performed to help in exploring biological differences in different racial/ethnic groups according to the molecular MM subtype and/or clinical presentation.”

The study reported on more than a decade’s worth of data from the Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project. Throughout the study period, there were 1.2 million hospitalizations related to MM, 4.6% (57,000) of which were associated with SCC.

Throughout the 12-year period, the average annual percent change (AAPC) showed an uptrend for all groups, although the percent change was higher for non-Hispanic Black patients (10.5%) compared with Hispanic patients (9.6%) and non-Hispanic White patients (7.9%). The researchers explained that their data did not account for patients who self-identify as multiracial or account for recurrent hospitalizations.

“Early detection and intervention may help in avoiding permanent paraplegia,” explained the researchers. “The increased rates of SCC in patients with MM found in our study may be related to better recognition and/or diagnosis of SCC. Other potential explanations may be related to the change in treatment landscape and/or longer survival of MM patients.”

Despite having higher AAPCs, non-Hispanic Black patients and Hispanic patients had lower rates of SCC hospitalizations.

Non-Hispanic White patients (4.9 per 100 MM hospitalizations) were more likely than non-Hispanic Black and Hispanic patients (4.2 and 4.0 per 100 MM hospitalizations, respectively) to be hospitalized due to SCC. Data from multivariate adjusted survey logistic regression showed that compared with non-Hispanic White patients, non-Hispanic Black patients (odds ratio [OR], 0.83; 95% CI, 0.78-0.88) and Hispanic patients (OR, 0.83; 95% CI, 0.76-0.91) had reduced risk of SCC-related hospitalizations, at 17% each.

Notably, despite SCC increasingly being identified in the outpatient setting, data on outpatient consultations were not considered in the study.

Reference

Hadidi S, Dongarwar D, Schinke C, et al. Racial differences in spinal cord compression related hospitalizations in patients with multiple myeloma. Clin Hematol Int. Published online February 3, 2023. doi:10.1007/s44228-023-00027-9