Population-Based Study Finds Racial Disparities in MDS Outcomes

Disparities in cancer care and outcomes between African American patients and White patients have been demonstrated in past studies, with African American patients often experiencing worse outcomes. Regarding myelodysplastic syndrome (MDS), however, an abstract presented at the 2022 American Society of Clinical Oncology Annual Meeting shows White patients to have worse overall survival (OS) outcomes than African Americans patients.

MDS encompasses a group of clonal myeloid neoplasms first defined as malignant in 2001. The causes of MDS are often unknown, but in some cases, it can occur secondary to mutations caused by cancer therapies or other external factors. MDS can also evolve into acute myeloid leukemia (AML). Considering that past studies have found African Americans to have worse outcomes than White patients in several solid tumor and hematological cancers, including AML, the current study aimed to characterize baseline traits and outcomes in patients with MDS.

Researchers analyzed data from the Survival, Epidemiology, and End Results (SEER) cancer registry to analyze outcomes in 37,564 patients aged 20 years or older with confirmed MDS between 2000 and 2013. Patients were stratified into low-, intermediate-, and high-risk disease groups.

A total of 34,543 White patients (91.9%) and 3021 Black patients (8.1%) were included in the study, which compared patients’ baseline characteristics, mortality rates per cause of death, and OS. The median ages at diagnosis were 76 and 71 years, respectively. There was a higher proportion of men in the White study population vs in the African American population (58% vs 49%). Further, more African American patients were considered low risk (22.8% vs 21.5%) and fewer patients were considered high risk (14.5% vs 16.3%).

The median OS for African American patients was 33 months vs 26 months in White patients, and they were shown to have a 21% reduced risk of MDS-related mortality (HR, 0.79; 95% CI, 0.76-0.83; P < .001). The most common causes of death in both patient cohorts was MDS/leukemia, cardiovascular disease, and other cancers. The relationship between race and OS remained statistically significant when baseline covariates were adjusted in a multivariate Cox proportional hazards regression model.

The study was limited by its retrospective nature; its reliance on data only available in SEER, and the lack of data on subtypes of MDS, which is a heterogenous group of clonal myeloid neoplasms. Even so, the finding that African American patients had better OS than White patients with MDS warrants further research, the authors conclude.

These data differ from prior research on the disparities between African American and White patients with hematological malignancies.

Reference

Lesegretain A, Laadem A, Fell G, Fathi AT. Comparison of demographics, disease characteristics, and outcomes between African American patients and White patients with myelodysplastic syndrome: a population-based study. Abstract presented at: 2022 American Society of Clinical Oncology Annual Meeting; June 3-7, 2022; Chicago, IL. Accessed June 22, 2022. Abstract 7051. https://meetings.asco.org/abstracts-presentations/208243