A Better Understanding of Black Myeloma Biology (And How Racism Plays a Role in Outcomes)

Multiple myeloma (MM), a cancer of plasma cells, is not only more common among African Americans (AA) but also presents differently compared to other racial groups.

This disparity has long puzzled researchers, but new studies presented at the 2024 American Society of Hematology (ASH) Annual Meeting provide fresh insights into Black myeloma biology and the impact of systemic racism on health outcomes.

The abstracts highlighted in this article include:

1. “Genomic Diversity and APOBEC-Mutational Landscape in African American Myeloma Patients”

2. “Mass Spectrometry Reveals Higher Prevalence of Multiple M-Proteins in African American Myeloma and Precursor Conditions”

3. “Structural Racism and Its Impact on Myeloma Outcomes in African Americans”

These studies are reshaping how we understand and address disparities in multiple myeloma care for Black patients.

Unique Genetic Insights from Black Myeloma Patients

The first abstract, “Genomic Diversity and APOBEC-Mutational Landscape in African American Myeloma Patients,” delves into the genetic characteristics of myeloma in Black patients. 

Using whole genome sequencing (WGS), researchers found that African Americans with myeloma tend to have lower activity of something called the APOBEC enzyme. This enzyme is crucial for DNA editing, and its decreased activity may influence the way myeloma develops and progresses in Black patients.

This finding underscores the need for personalized approaches to diagnosis and treatment. WGS is proving to be a vital tool in identifying these unique genetic signatures, potentially paving the way for targeted therapies.

Consider watching this interview video on whole genome sequencing to better understand how this technology is revolutionizing myeloma care.

The Role of Diagnostic Advances in Addressing Disparities

The second abstract, “Mass Spectrometry Reveals Higher Prevalence of Multiple M-Proteins in African American Myeloma and Precursor Conditions,” focuses on diagnostic innovations. Using mass spectrometry-based tools, researchers identified a higher prevalence of multiple M-proteins—markers of disease presence—in African American patients with multiple myeloma or its precursor conditions.

This discovery highlights the importance of advanced diagnostic methods to improve the detection and monitoring of myeloma in Black patients. It also suggests that without such tools, African Americans may face delays in diagnosis and treatment, exacerbating disparities.

These findings are a call to action for clinicians and researchers to prioritize access to sophisticated diagnostic technologies for underserved populations.

The Role of Racism in Myeloma Outcomes

The third abstract, “Structural Racism and Its Impact on Myeloma Outcomes in African Americans,” takes a hard look at the systemic factors affecting Black myeloma patients. The study found that structural racism—manifested through limited access to healthcare, socioeconomic barriers, and implicit bias—significantly influences survival rates and quality of care.

This abstract emphasized that even when Black patients have similar disease characteristics as their white counterparts, their outcomes often lag behind due to systemic inequities. Addressing these disparities requires more than scientific advances; it demands societal changes, policy reform, and greater inclusion of African Americans in clinical trials.

Proposed Solutions: Where Do We Go from Here?

The abstracts don’t just highlight the challenges; they also propose actionable solutions:

• Enhanced access to diagnostics: Increasing the availability of tools like mass spectrometry and whole genome sequencing in underserved communities to improve early detection and personalized treatment.

• Inclusion in research: Expanding the diversity of clinical trial participants to better represent African American patients and ensure treatments are effective across populations.

• Addressing structural barriers: Advocating for policy changes to improve access to healthcare and reduce socioeconomic inequities. This includes funding for community outreach and education to empower patients to seek timely care.

• Bias training for healthcare providers: Implementing mandatory training programs to address implicit biases and improve provider-patient interactions.

By combining these solutions with continued research, we can take significant steps toward closing the gap in myeloma care and outcomes for African American patients.

Bringing It All Together

These three abstracts presented at the 2024 ASH Annual Meeting highlight the complexity of Black myeloma biology and the broader societal issues that impact patient outcomes. From genetic differences to the structural barriers imposed by racism, it’s clear that solving these disparities requires a multifaceted approach.

For patients and caregivers, understanding both the biological and systemic factors influencing myeloma is crucial. Knowledge is power, and awareness can empower you to advocate for the care and resources you deserve.

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