Black Patients with MDS Show Better Survival Outcomes Than White Patients

Black patients with myelodysplastic syndromes (MDS) had better survival outcomes than white patients in a retrospective, population-based study of the relationship between race (Black, white) and baseline characteristics, overall survival, and cause of death in MDS in the United States.

Arnaud Lesegretain and colleagues from Harvard Medical School and other institutions in Boston discussed the findings during the 2022 Society of Hematologic Oncology (SOHO) Annual Meeting.

The researchers described the results as “unexpected” given that data from U.S. cancer registries indicate that Black patients have the highest mortality rate of any racial and ethnic group for all cancers combined—and for several cancers individually.

The study was based on the Surveillance, Epidemiology, and End Results (SEER) registry of the National Institutes of Heath and included 37,562 patients (Black, 8.1%; white, 91.9%) with MDS diagnosed between 2001 and 2013. The analysis covered the patients’ demographics, socioeconomic factors, disease subtype, mortality rate per cause of death, and survival outcomes.

Black patients exhibited longer overall survival (OS; hazard ratio [HR], 0.79; 95% CI, 0.76-0.83; P<.001): Median OS was 33 months for Black patients versus 26 months for white patients. This association was maintained in sensitivity analyses (multivariable and matching) adjusting for differences in baseline demographics and disease characteristics.

“The finding of Black [patients] having better OS outcomes than white patients was unexpected and needs to be further researched,” the investigators stated.

The investigators noted several limitations of their study, including that the study was retrospective and did not use clinical, molecular, or cytogenetics data nor risk scores (which were not available in SEER). Additionally, a large proportion of the study population had an undefined form of MDS, which was coded “MDS-NOS” in SEER. The investigators noted that the application of the MDS-NOS code in the SEER data varied significantly depending on region, ranging from 31.8% in Seattle to 60.1% in New Jersey.

“Our findings raise questions regarding the adequacy of coding and classification of MDS in U.S. cancer registries,” they noted.

Reference

Lesegretain A, Laadem A, Fell G, Fathi AT. Comparison of demographics, disease characteristics and outcomes between black and white patients with myelodysplastic syndrome: a population-based study. Abstract #MDS-556. Presented at the 2022 Society of Hematologic Oncology (SOHO) Annual Meeting, September 28-October 1, 2022.