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No significant differences were found in plasma cell leukemia outcomes among racial groups of hospitalized patients in a recent study.

Plasma cell leukemia (PCL) is an aggressive subtype of multiple myeloma (MM) with a poor prognosis. Prior studies have documented racial disparities among MM patients regarding prevalence, treatment outcomes, and mortality, but limited data exists for PCL. 

A study in Clinical Hematology International examined the racial/ethnic differences in PCL outcomes among hospitalized patients in the United States.

Study Population

There were 14,303 hospitalizations for patients with a primary PCL diagnosis in the Nationwide Inpatient Sample database between 2010 and 2019. In this cohort, 53.6% were male. Most (83%) were aged between 40 and 79 years, with 6.8% in the 18–39 year range and 10.2% at ≥80 years. The racial/ethnic distribution was as follows: 59.4% Non-Hispanic (NH) White, 22.2% NH-Black, 7.8% Hispanic, 4.6% NH-Other, and 5.9% with missing information about race/ethnicity.

Decade-Long Decline in Plasma Cell Leukemia Hospitalization With No Racial Disparities

The rate of hospitalizations for PCL decreased over the 10-year study period across the entire cohort; the average annual percentage change was 1.6 in each racial/ethnic group. No statistically significant association was observed between race/ethnicity and hospitalization rates among hospitalized patients with a primary PCL diagnosis. 

The non-significant differences among racial groups were as follows: between the NH-White group and Hispanic (odds ratio (OR): 0.47; 95% confidence interval (CI): 0.05–4.23, p=0.5), NH-Black (OR: 1.94; 95%CI: 0.3–3.54, p=0.95), and NH-Others (OR: 1.67, 95%CI: 0.47–5.89, p=0.42). The hospitalization rates were not significantly associated with death (OR: 1.85; 95%CI: 0.22–15.41, p=0.57).

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No Significant Associations in Hospitalization Rate Between Gender and Age

No statistically significant association was observed between gender and hospitalization rates (OR: 1.52; 95%CI: 0.67–3.42, p=0.32). There was also no significant association between age and hospitalization rates between the 18–39 year group and the 40–59 (OR: 3.78; 95%CI: 0.77–18.52, p=0.1), 60–79 (OR: 2.97; 95%CI: 0.65–13.49, p=0.16), and 80+ years (OR: 1.22; 95%CI: 0.2–7.29, p=0.83) groups. None of the other assessed factors had any significant association with PCL hospitalizations; these included zip code income quartile, hospital region and location, hospital teaching status, hospital bed size, and primary payer/insurance status.

In conclusion, the study found no significant differences among racial groups in hospitalizations or hospitalization-related mortality for PCL patients. These findings suggest that the factors driving increased hospitalization rates in MM may not be present to the same extent in PCL.

Source:

Wu, C., Dongarwar, D., & Hadidi, S. A. (2023). Racial disparities in plasma cell leukemia outcomes among hospitalized patients in the United States. Clinical Hematology International, 5(4). https://doi.org/10.46989/001c.87755