On Tuesday, the Multiple Myeloma Research Foundation (MMRF) held a workshop in Chicago titled “Racial Disparities in Multiple Myeloma: Its Effect on the African American Community.” The pilot program was MMRF’s first attempt at reaching out specifically to primary care physicians in underserved areas.

The program focused on why the risk of developing multiple myeloma is twice as great in African-Americans than it is in Caucasians. Possible explanations include the presence of a condition called MGUS (monoclonal gammopathy of undetermined significance), socioeconomic status, lifestyle and environmental factors, and genetics.

MGUS is a benign condition characterized by elevated levels of antibody in the blood. While MGUS is considered to be a precursor to multiple myeloma, the risk of progression from MGUS to myeloma is only one percent per year.

African-Americans are three times more likely to have MGUS than Caucasians, even though the two groups have a similar rate of progression to myeloma. Indeed, MGUS has been shown to be the strongest risk factor for developing myeloma. Scientists anticipate this will be important in future health and population studies.

Occupation-based low socioeconomic status has been shown to account for 49 percent of the excess incidence of multiple myeloma in African-Americans. Researchers speculate that a low socioeconomic status may mask negative environmental or lifestyle characteristics. For instance, poor housing can result in exposure to chemicals and infectious agents, and poor nutrition can weaken the immune system.

The workshop also stressed that a balanced representation of patients in clinical trials is important to accurately examine the effects of treatments. Studies show that African-Americans are less likely to partake in clinical trials and epidemiological studies. Thus, clinical trials do not accurately mirror the general myeloma patient population.

Researchers agree that equal access to treatments and technologies is a major barrier to overcoming racial disparities in multiple myeloma. The workshop targeted primary care physicians practicing in underserved areas to help bring attention to these issues.

Other topics discussed at the meeting included signs and symptoms of multiple myeloma, novel therapies and clinical trials, and supportive care. These will be described in a subsequent article.