Lower Education Levels May Decrease Survival in Multiple Myeloma

A study published in BMC Cancer analyzed the relationship between education level and survival in multiple myeloma and observed that patients with lower education levels may have lower survival rates.

“In recent years, with the continuous advent of new drugs and new treatments, the prognosis of patients with [multiple myeloma] MM has been greatly improved. However, not all MM patients benefit equally from these improvements,” the researchers explained, adding, “The impact of demographic and socioeconomic factors on the prognosis and survival of patients with MM has not been reported in developing countries such as China.”

The retrospective study included 773 newly diagnosed multiple myeloma patients at nine China-based centers between January 2006 and July 2019. Patient treatments were stratified by transplantation and nontransplantation. Progression-free survival (PFS) was defined as the time from initial multiple myeloma diagnosis to disease progression, death, or final follow-up; overall survival (OS) was defined as the time from initial diagnosis to death or final follow-up.

A little more than two-thirds of multiple myeloma patients (69.2%) had low education levels. Patients with low levels of education tended to be older, and a greater proportion of them—compared to those with high education levels—were unemployed, had lower annual incomes, and did not have insurance. Patients with lower education levels were also more likely to have international staging system (ISS) stage III classification and elevated lactate dehydrogenase (LDH) levels, and were less likely to undergo transplantation. Median PFS in the higher education level group was 67.50 months (95% confidence interval [CI], 51.66 to 83.39 months), more than double that of the lower education level group (30.60 months; 95% CI, 27.38 to 33.82 months). Median OS was also better in the higher education level group (122.27 months; 95% CI, 117.05 to 127.49 months) than the lower education level group (58.83 months; 95% CI, 48.87 to 62.79 months). Upon multivariable analysis, higher education levels were associated with lower relapse rates and higher survival rates.

The researchers concluded that multiple myeloma patients who have higher levels of education “have a better economic foundation, can seek medical treatment in a more timely manner, can choose the best treatment regimens and can be treated more regularly. Therefore, the results of this study indicate that we can use the education level of newly diagnosed patients to evaluate the prognosis of these patients and to create more reasonable treatment plans.”