Patient outcomes in MM: Global disparities

The treatment of multiple myeloma (MM) has improved over time, with more standardized therapies becoming available globally. However, significant differences exist in the incidence of MM, access to novel therapies and transplant, and survival outcomes. The primary factors attributable to these discrepancies include age, sex, ethnicity, socioeconomic status, and geographical location.¹

Here, we summarize the discrepancies between the management of MM globally, with a focus on the differences between and within international regions.   

Regional disparities in MM

Socioeconomic status and its impact on treatment can be observed at a large scale between the margins of global wealth. However, this disparity can also be seen within small geographic regions, where discrepancies in resources are comparatively smaller but still influence both the likelihood of seeking and access to treatment. Other factors, such as age, do not differ significantly between countries but are consistently related to poorer access and survival, regardless of location.¹

A summary of the incidence and disparity in treatment for MM is shown by geographical region in Figures 1, 2 and 3.

Figure 1. Disparities in MM incidence and treatment in the Americas*

*Data from Mateos, et al.¹and Hungria.²

Figure 2. MM Incidence and treatment in Asia*  

HSCT, hematopoietic stem cell transplantation.
*Data from Ganguly, et al.³ and Tan, et al.⁴

Figure 3. MM incidence and treatment in Europe*  

*Data from Ludwig, et al.⁵

Global disparities in MM

Globally, factors consistently related to improved outcomes in MM included access to novel therapies, private treatment facilities, socioeconomic status, and younger age.¹ Disparities between regions were more difficult to establish, with the most significant differences noted within countries or smaller communities. New Zealand and select European countries presented with the highest overall likelihood of survival, but internal analysis also revealed a spectrum of healthcare quality comparable to countries with a lower likelihood of survival.⁵ A snapshot of the global differences in myeloma treatment are shown in Figure 4.

Figure 4. Global disparities in MM treatment*  

*Data from Mateos, et al.¹

Conclusion

The challenges to healthcare equality in MM management vary by geographical regions. However, a few recurring factors present as consistent determinants of poor outcomes including, older age, and socioeconomic status. Whilst these factors are common worldwide, their influences are most prevalent when examined within each region.

Sufficient research from which to draw clear conclusions regarding global MM is lacking. However, existing research has identified specific populations and factors for further research and areas on which outreach effort should be focused, notably in populations with lower socioeconomic status and older age.