Multiple myeloma: Disparities Persist in Outcomes Despite Treatment Advances

Despite meaningful progress in treating multiple myeloma, a cancer of plasma cells, research presented at the American Society of Clinical Oncology (ASCO) annual meeting in 2025 highlights that not all patients are benefiting equally. Socioeconomic factors and co-existing health conditions continue to play a significant role in patient outcomes.

Income and Geographic Disparities in Multiple Myeloma Mortality

An analysis of incidence-based mortality (IBM) rates for multiple myeloma from 2000 to 2021 revealed persistent disparities based on household income and geographic location. The study, which used data from 17 cancer registries, found that individuals in lower-income brackets experienced significantly higher mortality rates [[1]].

Specifically, patients from households earning less than $40,000 annually had an IBM rate of 7.3 per 100,000, nearly double the 5.31 per 100,000 rate observed in households earning over $120,000. People living in rural areas also experienced higher mortality rates (6.14 per 100,000) compared to those in metropolitan areas (5.94 per 100,000). While overall IBM rates declined across all groups during the study period,the gap between lower-income or rural patients and their wealthier,urban counterparts remained consistent.

Researchers attribute these disparities to differences in insurance coverage, access to novel therapies, and fewer specialized healthcare resources in underserved communities. Rural patients often face long travel distances to reach oncologists or cancer centers, and low-income individuals may delay care due to high costs or inadequate insurance.furthermore,clinical trials and advanced diagnostics are more readily available at large academic centers in metropolitan areas,which are often inaccessible to rural populations.

Did You Know? The American Cancer Society estimates that in 2025,about 35,730 new cases of multiple myeloma will be diagnosed in the United States.

Impact of Comorbidities on Multiple Myeloma Outcomes

A separate retrospective chart review of 267 patients with confirmed multiple myeloma examined the impact of comorbidities on disease progression and overall survival. The study, published in the Journal of Clinical Oncology, assessed comorbidities such as chronic kidney disease (CKD), atrial fibrillation (AF), coronary artery disease, congestive heart failure, diabetes mellitus, COPD, stroke, liver disease, and prior malignancy.

CKD emerged as a significant risk factor for poor outcomes. Patients with CKD were more likely to have high-risk multiple myeloma (8.4% vs. 1.7%; P =.019), be diagnosed at R-ISS stage III (11.0% vs. 1.4%; P < .001), and experience mortality (12.3% vs. 4.0%; P = .026) compared to those without CKD.