A new study has investigated the interaction between multiple myeloma, diabetes, and race.
Multiple myeloma is known to be twice as common in Black people than white, and diabetes also disproportionately affects Black patients, US researchers say.
So, Dr Urvi Shah of Memorial Sloan Kettering Cancer Center, New York, USA, and colleagues looked at how the two conditions can interact, and the effect that race has on this interaction.
They analysed figures on 5,383 multiple myeloma patients, of whom 15% had diabetes – 12% of the white patients and 25% of the Black patients.
Overall survival for those with diabetes was 27% lower than those without diabetes. White patients with diabetes had lower survival than those without, but in contrast, there was no survival difference among Black patients with or without diabetes.
Obesity was also linked to better survival in Black patients, but not white patients.
In studies with genetically modified mice, the team then found that multiple myeloma grew faster in diabetic animals. These had higher levels of a protein indicating greater activation of the mTOR pathway, known for aiding cell growth and proliferation. Details appeared in the journal Blood Advances recently.
The authors state: “Our study is the first to evaluate racial differences in diabetes mellitus prevalence and survival in multiple myeloma as well as the effect of diabetes mellitus on tumour growth in mouse models.”
Dr Shah commented: “We knew from prior studies that patients with multiple myeloma and diabetes have lower survival rates, but what we did not know is how these outcomes differ between races.
“Diabetes was actually associated with worse survival outcomes among white individuals with myeloma, but not Black individuals.
“This study suggests that we may improve patient outcomes further by treating diabetes at the same time as multiple myeloma.”
Shah UA, Moshier EL, Derkach A, Huang Y, Mailankody S, Tan CR, Maclachlan KH, Hultcrantz M, Korde N, Hassoun H, Thibaud S, Sanchez L, Rodriguez C, Richard S, Richter J, Rossi A, Cho HJ, Lesokhin AM, Chari A, Usmani SZ, Jagannath S, Parekh S, Gallagher EJ. (2023) “Prevalence and impact of diabetes on survival of patients with multiple myeloma in different racial groups.” Blood Advances, doi: 10.1182/bloodadvances.2023010815
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