Multiple myeloma (MM) is a fatal plasma cell dyscrasia with a median overall survival of 5 to 10 years. MM progresses from the more common but often subclinical precursor states of monoclonal gammopathy of undetermined significance (MGUS), and smoldering multiple myeloma (SMM) to overt MM. There are large racial disparities in all stages of the disease. Compared with Whites, Blacks have an increased MGUS and MM risk and higher mortality rate, and have not experienced the same survival gains over time. The roots of this disparity are likely multifactorial in nature. Comparisons of Black and White MGUS and MM patients suggest that differences in risk factors, biology, and clinical characteristics exist by race or ancestry, which may explain some of the observed disparity in MM. However, poor accrual of Black MGUS and MM patients in clinical and epidemiological studies has limited our understanding of this disparity and hindered its elimination. Disparities in MM survival also exist but appear to stem from inferior treatment utilization and access rather than underlying pathogenesis. Innovative and multidisciplinary approaches are urgently needed to enhance our understanding of disparities that exist at each stage of the MM disease continuum and facilitate their elimination.

中文翻译：

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剖析多发性骨髓瘤的种族差异。

多发性骨髓瘤（MM）是致命的浆细胞发育不良，中位总生存期为5至10年。MM从意义不明的单克隆丙种球蛋白病（MGUS）的较常见但经常为亚临床前体状态发展而来，并将多发性骨髓瘤（SMM）闷烧为明显的MM。在疾病的所有阶段，种族差异很大。与白人相比，黑人的MGUS和MM患病风险增加，死亡率更高，并且随着时间的流逝没有获得相同的存活率。这种差异的根源可能是多因素的。黑白MGUS和MM患者的比较表明，种族或血统存在危险因素，生物学和临床特征方面的差异，这可能解释了MM中观察到的某些差异。然而，在临床和流行病学研究中，黑人MGUS和MM患者的病死率低，限制了我们对这种差异的理解，并阻碍了这种差异的消除。MM生存率的差异也存在，但似乎是由于治疗利用和获取水平较差，而不是潜在的发病机理引起的。迫切需要创新和多学科的方法，以加深我们对MM疾病连续性各个阶段存在的差异的理解，并促进消除这些差异。