Incidence Of Multiple Myeloma Research Articles

Multiple myeloma incidence, mortality, and prevalence estimates and projections, Australia, 1982-2043: astatistical modelling study.

To examine changes in multiple myeloma incidence and mortality rates during 1982-2018, and to estimate its incidence, mortality, and prevalence for 2019-2043. Population-based statistical modelling study; analysis of and projections based on Australian Institute of Health and Welfare multiple myeloma incidence, mortality, and survival data. Australia, 1982-2018 (historical data) and projections to 2043. Changes in multiple myeloma incidence and mortality rates, 1982-2018, determined by joinpoint regression analysis (age-standardised to 2021 Australian population); projection of rates to 2043 based on age-period-cohort models; estimated 5- and 30-year prevalence of multiple myeloma (modified counting method). The incidence of multiple myeloma increased during 1982-2018 (eg, annual percentage change [APC], 2006-2018, 1.9%; 95% confidence interval [CI], 1.7-2.2%), but the mortality rate declined during 1990-2018 (APC, -0.4%; 95% CI, -0.5% to -0.2%). The age-standardised incidence rate was projected to increase by 14.9% during 2018-2043, from 8.7 in 2018 to 10.0 (95% CI, 9.4-10.7) new cases per 100 000 population in 2043; the mortality rate was projected to decline by 27.5%, from 4.0 to 2.9 (95% CI, 2.6-3.3) deaths per 100 000 population. The annual number of people newly diagnosed with multiple myeloma was estimated to increase by 89.2%, from 2120 in 2018 to 4012 in 2043; the number of deaths from multiple myeloma was projected to increase by 31.7%, from 979 to 1289. The number of people living with multiple myeloma up to 30 years after initial diagnosis was projected to increase by 163%, from 10 288 in 2018 to 27 093 in 2043, including 13 019 people (48.1%) diagnosed during the preceding five years. Although the decline in the mortality rate was projected to continue, the projected increases in the incidence and prevalence of multiple myeloma in Australia over the next 25 years indicate that investment in prevention and early detection research, and planning for prolonged treatment and care, are needed.

The Epidemiological Particularities of Malignant Hemopathies in French Guiana: 2005-2014.

French Guiana is a French Overseas territory with singular features: it has a high prevalence of HIV and HTLV-1, its population is ethnically mixed, with widespread poverty, and up to 20% of the population lives in geographic isolation. In this context, we used registry data to estimate incidence and mortality due to hematological malignancies and to compare them with France and tropical Latin America. ICD codes C90 and C88 were compiled between 2005 and 2014. The direct standardization of age structure was performed using the world population. Survival analysis was performed, and Kaplan-Meier curves were drawn. The overall standardized incidence rate was 32.9 per 100,000 male years and 24.5 per 100,000 female years. Between 2005 and 2009, the standardized incidence rate was 29.6 per 100,000 among men and 23.6 per 100,000 among women, and between 2010 and 2014, it was 35.6 per 100,000 among men and 25.2 per 100,000 among women. Multiple myeloma/plasmocytoma and mature t/NK cell lymphomas, notably adult t-cell lymphoma/leukemia due to HTLV-1 infection, were the two most common hematologic malignancies and causes of death. Non-Hodgkin's lymphoma incidence estimates were greater than global estimates. After adjusting for age, sex, and type of malignancy, people born in a foreign country independently had a poorer case-fatality rate, presumably reflecting difficulties in accessing care. The epidemiology of hematological malignancies in French Guiana has features that distinguish it from mainland France or from Latin America. The incidence of multiple myeloma and adult t-cell lymphoma/leukemia was significantly greater in French Guiana than in France or other Latin American countries.

Association between CTX-1 and Fibulin-1 Serum Levels with Pathogenesis of Multiple Myeloma Cancer.

Multiple myeloma (MM) is the second most prevalent blood cancer after non-Hodgkin lymphoma. It is identified by the excessive production of abnormal monoclonal immunoglobulins, which can result in various clinical symptoms such as destructive bone lesions, renal dysfunction, anemia, and immunodeficiency. The current study aims to evaluate the serum levels of carboxy-terminal collagen crosslinks 1 (CTX-1), Fibulin-1, vitamin D3, LDH, and albumin in MM patients and their significance for early diagnosis. This study included 30 healthy controls (11 males, 19 females) and 60 patients with multiple myeloma (37 males and 23 females), aged between 40-60 years. Five-milliliter blood samples were collected and stored at -20°C. Afterward, enzyme-linked immunosorbent assay (ELISA) kits were used to estimate the concentrations of CTX-1, Fibulin-1, and vitamin D3. Additionally, LDH and albumin levels were determined using the automated biochemistry analyzer. This study revealed that the majority of patients with multiple myeloma are between the ages of 51 and 60 years. The serum concentrations of CTX-1, Fibulin-1, and LDH were significantly increased in the multiple myeloma patients compared to the healthy control group. In contrast, the serum level of vitamin D3 was significantly decreased in patients with MM. Our results indicate that the incidence of multiple myeloma is higher in males than in females. Additionally, the serum concentrations of CTX-1 and Fibulin-1 were significantly higher in the multiple myeloma patients compared to the healthy control group, indicating their potential for early detection and as therapeutic targets.

Correlation Between Bariatric Surgery and the Risk of Multiple Myeloma: Results from an Evidence-Based Strategy.

We conducted a meta-analysis of current literature to assess whether bariatric surgery(BS) has a positive effect on reducing the risk of multiple myeloma(MM). Relevant studies meeting the criteria were systematically reviewed using databases such as PubMed, Web of Science, Embase (Ovid platform), MEDLINE, and the Cochrane Library. The meta-analysis utilized hazard ratios (RR) and 95% confidence intervals (CI) to analyze the correlation between BS and the risk of MM. STATA software (version 12.0) was employed for the meta analysis. The meta-analysis included 10 eligible studies, involving 2,452,503 patients with obesity. The results demonstrated a significant reduction in the risk of multiple myeloma in patients with obesity after bariatric surgery compared to non-surgical patients with obesity (RR = 0.51, 95%CI: 0.31-0.84). Subgroup analyses revealed a decreased probability of developing multiple myeloma in European patients with obesity and North American patients with obesity who underwent bariatric surgery. Studies with a sample size greater than or equal to 100,000 indicated a significantly reduced risk of multiple myeloma in patients with obesity undergoing bariatric surgery compared to the non-surgical group (RR: 0.45, 95%CI: 0.23-0.88, P < 0.02). Two publications before 2010 showed no significant difference in the incidence of multiple myeloma between the surgical and non-surgical groups (RR: 0.61, 95% CI: 0.14-2.63, P = 0.504), while publications after 2010 demonstrated a reduced incidence in the surgical group (RR: 0.51, 95% CI: 0.30-0.86, P = 0.012). Our meta-analysis results suggest a reduced risk of multiple myeloma in patients with obesity following bariatric surgery. CRD42023485668.

Recent trends in incidence, survival and treatment of multiple myeloma in Finland – a nationwide cohort study

This study aimed to determine the incidence and prevalence of multiple myeloma (MM) in Finland in 2015–2019, to characterize adult patients newly diagnosed with MM, and to follow-up their overall survival (OS) and treatment patterns until the end of 2020. We sourced the data on inpatient and outpatient diagnoses, outpatient medication use, and date of death from comprehensive, nationwide registers. We identified 2037 incident patients with MM in 2015–2019. On average, the annual crude incidence was 8.8 and the age-standardized incidence (World Standard Population) was 3.3 per 100,000. The crude prevalence at the end of 2019 was 32.7 cases per 100,000 inhabitants ≥ 18 years of age. Median age of the patients at first diagnosis (index date) was 71 years, and 48% were female, the median follow-up being 2.4 years. The median OS was estimated at 4.5 years. The proportion of the patients receiving autologous stem cell transplantation (ASCT) within one year since the index date was 24%, with little variation across study years. Conversely, the proportion of all patients receiving lenalidomide within one year since the index date increased from 27 to 48% overall, and from 39 to 81% among ASCT recipients. The estimated median relapse-free survival after ASCT was 2.9 years. Information on in-hospital MM medication administrations was available for a subset of the study cohort. In this subset, 85.8% of the patients received immunomodulatory drugs and/or proteasome inhibitors within the first year after the index date.

Abstract B113: A multi-ethnic population-based study of multiple myeloma disparities: Results from a recruitment pilot

Abstract To understand multiple myeloma (MM) incidence and survivorship disparities, we established the Precision MEDicine, EqUity and Disparities Research in MultipLe MyeLomA (MEDULLA) study. Our study contacted 400 MM patients reported to the Cancer Registry of Greater California (CRGC) between 2013-2018. We contacted 100 adult individuals from four racial/ethnic groups: Blacks, Whites, Latinos, and Asians with MM diagnosis. Data collection included variables reported to the CRGC, a self-administered survey, and biospecimen saliva collection. The survey focused on demographics, risk factors, cancer treatment, family history, quality of life, and social determinants of health. We also used census tract level features obtained by the American Community Survey 2007-2011. A total of 95 patients participated in the survey (overall response rate = 24%). We performed chi-square test, fisher’s exact test, or Wilcoxon test to obtain two-sided p-values for univariate testing for associations with responding to the survey. We further perform multivariable logistic regression using a stepwise approach under the Akaike information criterion with age and sex kept as covariates. These methods were stratified by Whites and Non-Whites separately which we were able to find important trends. The highest response received was from Whites at 44.2%, with significantly lower rates in all minority groups (&amp;lt;20% for all groups). Response rates were higher for patients living in areas with higher median annual incomes and education. For every 1% increase in poverty rates, Whites living in such neighborhoods were 3% less likely to respond to the survey (p=0.04). For every 10% increase in the proportion of individuals having a college degree, responding to the survey increased by 1.17 units for minorities in that neighborhood (p=0.07). Minorities living in neighborhoods with high proportions of adults without a high school diploma and high unemployment rates are less likely to respond (p=0.02 and p=0.047, respectively). In conclusion, we found significantly lower participation rates among minority groups, with socio-economic factors affecting response rates. We suggest that future studies develop community-focused and culturally tailored strategies to understand MM etiology and survivorship in such populations. Citation Format: April P. Vang, Angelica Perez, Juanita Elizabeth Quino, Ana Estrada, Eric Stewart, Rosemary Cress, Luis Carvajal-Carmona. A multi-ethnic population-based study of multiple myeloma disparities: Results from a recruitment pilot [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B113.

Freedo mm: A Multicenter Observational Study of Multiple Myeloma in Second Relapse in Colombia

Introduction: The incidence of multiple myeloma (MM) has been increasing globally (Institute for Health Metrics and Evaluation ; Cancer Research UK 2021), particularly in high-income countries (Ferlay J et al. (2020); Cowan et al. 2018). However, low-income countries, including Colombia, have also experienced a progressive increase in new cases (Fondo Colombiano de Enfermedades de Alto Costo. Cuenta de Alto Costo (CAC) ; Martínez Cordero et al. 2020). In the context of MM, the duration of progression free survival decreases after each relapse rendering as highly important the election of and adequate treatment (Yong et al. 2016), yet there is a lack of local data on patients experiencing a second relapse in Colombia to guide these decisions. This study aims to characterize Colombian patients with MM in second relapse, the current treatment patterns, and assess clinical response to address this knowledge gap. Methods: An observational retrospective study was conducted, utilizing chart review data from five specialized cancer treatment institutions in Colombia. Adult MM patients with diagnosed second relapse between January 1, 2013 and June 30, 2021 who had received at least two prior lines of treatment including lenalidomide and a proteasome inhibitor were included. Patients receiving only palliative care were excluded. Data on the effectiveness and safety of treatment patterns were collected from the start of the second relapse treatment pattern until the occurrence of treatment withdrawal, death, initiation of treatment pattern for third relapse diagnosed, loss of follow-up or study cutoff date (June 30, 2022), whichever happened earlier. The main outcomes were progression free survival (PFS), time to treatment failure (TTF), overall survival (OS), and overall response rate (ORR). All variables were analyzed descriptively utilizing appropriate statistics measures such as, means or medians, with corresponding standard deviation or interquartile range for continuous variables, and frequencies and percentages for categorical variables. OS was determined using the Kaplan-Meier method. Results: A total of 84 Patients were included from 5 centers in 3 of the Colombian regions (Andean, Pacific and Caribbean), 47 (56%) were male. The mean age at the time of MM diagnosis was 62.3 (SD 11.7) years. On average, the time from initial diagnosis to the occurrence of the second relapse was 3.6 (SD 2.1, min: 0.6 max: 11.2) years. The most frequent type of relapse observed was biochemical relapse, accounting for 42 cases (51%). Immunoglobulin levels were used as biomarkers, with IgA M-protein (g/dL) measuring 0.7 (SD 2.8, min:0 max: 16.2) and IgG M-protein (g/dL) measuring 31.8 (SD 185.4, min 0, max: 1,144.3). Furthermore, 41 patients (49%) exhibited bone lesion as a sign of second relapse. The most frequent treatments received for second relapse included lenalidomide 33 (14.7%), carfilzomib 29 (12.9%), bortezomib 23 (10.3%) and daratumumab 22 (9.8%). Among the patients who received lenalidomide, 87.9% had received bortezomib as first-line therapy, while 18.2% leniladomide. Conversely, 75.8% had received lenalidomide as second-line therapy, and 45.5% bortezomib. Table 1 displays the main outcomes according to the treatment received. Regardless of the treatment, the average PFS was 12.7 (IQR 3.7-23.4) months, the TTF was 5.3 (IQR 1.9-12.9) months, and the ORR was 47.1%. Figure 1 illustrates the OS, revealing that at 27.5 months 50% of the study population had either died (21, 25%) or been censored (21, 25%). Treatment-emergent adverse events (TEAE) were reported in 10 patients (11.9%). The most frequent TEAE were anemia and neutropenia, reported in 2 patients. At the end of study cut off 21 patients (25%) had died, 8 (9.5%) had discontinued treatment, 42 (50%) had a third relapse, 4(4.8%) were lost to follow-up, 9 (10.7%) were still undergoing treatment. Conclusions: The FreedoMM study is the first to our knowledge, to describe comprehensively the characteristics, treatment patterns, and clinical response of Colombian patients experiencing a second relapse of MM. The study highlights the poor outcomes observed in this specific population. Indeed, the study underscore the clear necessity for additional research and the development of treatment guidelines tailored specifically to patients in their second of MM in Colombia and other similar countries.

Multiple Myeloma and DALY in the USA: Insights of the Global Burden of Disease

Introduction: In contrast to the global trends, which indicate an escalating incidence and mortality of Multiple Myeloma (MM), the United States presents an inverse scenario. The successful development and deployment of therapeutic interventions have led to an appreciable decrease in mortality by 18%. Among the diverse array of prognostic factors associated with MM, age stands out as a significant element, typically associated with poor prognosis. With these considerations in mind, our study aimed to undertake a systematic analysis of the incidence, mortality, and Disability-Adjusted Life Years (DALY) related to MM over a decade in the United States. Methods: The Global Burden of Disease (2019) offers extensive assessments of the incidence, mortality, and DALY in the United States from 1990 to 2019. The data was gathered using the Global Health Data Exchange query tool. We analyzed the annual percentage change (APC) over this period and compared different age groups to enhance the current trend of incidence, mortality, and DALY in the United States between 2009-2019. Results: Our analysis was structured around three distinct age groups-15-49 years, 50-74 years, and 75+ years, with each category further stratified by gender. For the 15-49 years cohort, males consistently exhibited higher average Disability-Adjusted Life Years (DALYs) at 15.60 per 100,000, as compared to their female counterparts, who averaged at 10.05. Intriguingly, the Annual Percentage Change (APC) displayed a downward trajectory for DALYs, Deaths, and Incidence rates over the period under study, with respective APC values of -1.79, -1.81, and -1.95. This trend indicates a consistent improvement in health outcomes for this age group. On the other hand, the 50-74 years age group revealed a significantly ascending trend in all health measures. Here, females and males recorded average DALYs of 98.13 and 143.33 per 100,000, respectively. The APC values for this group underscored an increasing trajectory-0.72 for both DALYs and Incidence and 0.92 for Deaths-signifying a worsening in health outcomes over the duration of observation. Lastly, in the oldest age group of 75+ years, the DALYs surged to 235.78 for females and 379.87 for males per 100,000. Although the APC values for this age group were positive, they were relatively lower than those for the 50-74 years group, with APC values of 0.62 for DALYs, 0.44 for Deaths, and 0.39 for Incidence. Conclusion: New therapies in MM have decreased the average of DALY in the US over the studied decade. Between the ages 15-49 years, the study's results align with the current data correlating younger age with a better prognosis. However, when divided into age categories, the subgroup from 50-74 years showed a possible rapid deterioration in health outcomes when compared with patients above 75 years old. Additional studies are needed to better understand this underlying pathophysiology to have better results and develop further therapies.

Differential Chromatin Organization between t(4;14) and Non-t(4;14) Multiple Myeloma Driven By the Histone Methyltransferase NSD2

Background: The incidence of multiple myeloma (MM) with t(4;14) translocation is ~15% of newly diagnosed MM (NDMM), and is associated with poor prognosis and high-risk disease. Recent analysis of t(4;14) genomics indicate that the location of the chromosome 4 (chr4) breakpoint can significantly segregate patient outcome regardless of therapeutic intervention. Translocation of IGH regulatory elements from chr14, drive the expression of NSD2 (chr4), a histone (H3) methyltransferase responsible for di-methylation of H3 lysine 36 (H3K36me2), a mark of active chromatin. Depending upon the location of the chr4 breakpoint, different isoforms of NSD2 are expressed, including full-length (NSD2-FL) and various N-terminus truncations (NSD2-TR). The mechanisms of how the location of the chr4 breakpoint and the functionalities of NSD2 isoforms may contribute to a higher risk biology in t(4;14) MM patients is not known. Here we compare and contrast the 3D chromosomal organization of t(4;14)-NSD2-FL, t(4;14)-NSD2-TR and non-t(4;14) in pre-clinical MM models. Results: Comparative analysis of chromosome conformation capture (Hi-C) indicates that there is a decrease in medium-to-long range chromosomal looping interactions accompanied by an increase in short-range interactions from t(4;14) vs. non-t(4;14) models (Figure A). Accordingly, relative quantification of chromosomal contact probabilities of intra-chromosomal (cis) contacts increase in frequency from non-t(4;14) (77%) vs. t(4;14)-NSD2-FL (87%) vs. t(4;14)-NSD2-TR (89%). Evaluation of active/inactive (A/B) 3D genomic compartments between non-t(4;14) and t(4;14) models suggest significant compartment switches (~30% genome; combined A-to-B and B-to-A). Analysis of gene neighborhoods through topologically associated domains (TADs) suggests that there are decreases in contacts at the TAD boundary regions in t(4;14)-NSD2-TR vs. t(4;14)-NSD2-FL vs. non-t(4;14) models. TAD sizes are also generally smaller in size, from t(4;14)-NSD2-TR vs. t(4;14)-NSD2-FL vs. non-t(4;14). Complimentary analysis of activity by contact (ABC) to assess the potential influence of proximal and distal enhancers on gene activity confirms there is a decrease in ABC scores when comparing t(4;14) vs. non-t(4;14). Assessment of global chromatin accessibility (ATAC-Seq) indicate significant consensus open peaks (~135k), differentially accessible (DA) peaks (~2.6k), and differential closed peaks (~8.8k) in t(4;14) vs. non-t(4;14). Principal component (PC) analysis demonstrated a unique grouping of t(4;14) models compared to a very heterogenous distribution of non-t(4;14) models. DA regions in t(4;14) were found to be primarily more enriched in both intronic and intergenic regions, and within proximal and distal promoters. Analysis of histone marks was used to assess differences in global active enhancers (H3K4me1, H3K27ac), repressive chromatin (H3K9me3, H3K27me3), and active transcription (H3K36me2/3, H3K4me3) between non-t(4;14) and t(4;14). Active marks were shown to be increased, and repressive marks decreased in t(4;14) vs. non-t(4;14) models that also correlated with DA peaks. Enhancer ranking suggests the frequency of potentially poised superenhancers increase in t(4;14) vs. non-t(4;14). Differential expression (DE) analysis between t(4;14) and non-t(4;14) was highly correlative with DA peaks (Figure B). In addition, distinctive transcriptional signatures between non-t(4;14), t(4;14)-NSD2-FL, and t(4;14)-NSD2-TR were identified. Conservative (DA+DE) pathway enrichment suggests multiple and distinct biological processes including cell adhesion through adherens junctions, cell-cycle regulation through mitotic checkpoints, chromosomal reorganization through depolymerization of the nuclear lamina, and epithelial to mesenchymal transition. Conclusions: Systematic chromosomal re-arrangement and accessibility driven by differential epigenetic deposition of histone regulatory marks, differentiates t(4;14) from non-t(4;14) MM biology. These analyses suggest that given the nature of the translocation, and additionally the location of the chr4 breakpoint, result in major 3D chromosomal structural rearrangement, mediating biological programs that may explain the differences between successful and poor interventional therapies for this subset of MM disease.

Non-Toxicological Role of Aryl Hydrocarbon Receptor in Obesity-Associated Multiple Myeloma Cell Growth and Survival.

Obesity is not only a risk factor for multiple myeloma (MM) incidence, but it is also associated with an increased risk of progression from myeloma precursors-monoclonal gammopathy of undetermined significance-and smoldering myeloma. Adipocytes in the bone marrow (BMAs) microenvironment have been shown to facilitate MM cell growth via secreted factors, but the nature of these secreted factors and their mechanism of action have not been fully elucidated. The elevated expression of aryl hydrocarbon receptor (AhR) is associated with a variety of different cancers, including MM; however, the role of AhR activity in obesity-associated MM cell growth and survival has not been explored. Indeed, this is of particular interest as it has been recently shown that bone marrow adipocytes are a source of endogenous AhR ligands. Using multiple in vitro models of tumor-adipocyte crosstalk to mimic the bone microenvironment, we identified a novel, non-toxicological role of the adipocyte-secreted factors in the suppression of AhR activity in MM cells. A panel of six MM cell lines were cultured in the presence of bone marrow adipocytes in (1) a direct co-culture, (2) a transwell co-culture, or (3) an adipocyte-conditioned media to interrogate the effects of the secreted factors on MM cell AhR activity. Nuclear localization and the transcriptional activity of the AhR, as measured by CYP1A1 and CYP1B1 gene induction, were suppressed by exposure to BMA-derived factors. Additionally, decreased AhR target gene expression was associated with worse clinical outcomes. The knockdown of AhR resulted in reduced CYP1B1 expression and increased cellular growth. This tumor-suppressing role of CYP1A1 and CYP1B1 was supported by patient data which demonstrated an association between reduced target gene expression and worse overall survival. These data demonstrated a novel mechanism by which bone marrow adipocytes promote MM progression.

Multiple myeloma risk in relation to long-term air pollution exposure - A pooled analysis of four European cohorts

BackgroundAir pollution is a growing concern worldwide, with significant impacts on human health. Multiple myeloma is a type of blood cancer with increasing incidence. Studies have linked air pollution exposure to various types of cancer, including leukemia and lymphoma, however, the relationship with multiple myeloma incidence has not been extensively investigated. MethodsWe pooled four European cohorts (N = 234,803) and assessed the association between residential exposure to nitrogen dioxide (NO2), fine particles (PM2.5), black carbon (BC), and ozone (O3) and multiple myeloma. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level. ResultsDuring 4,415,817 person-years of follow-up (average 18.8 years), we observed 404 cases of multiple myeloma. The results of the fully adjusted linear analyses showed hazard ratios (95% confidence interval) of 0.99 (0.84, 1.16) per 10 μg/m³ NO2, 1.04 (0.82, 1.33) per 5 μg/m³ PM2.5, 0.99 (0.84, 1.18) per 0.5 10−5 m−1 BCE, and 1.11 (0.87, 1.41) per 10 μg/m³ O3. ConclusionsWe did not observe an association between long-term ambient air pollution exposure and incidence of multiple myeloma.

Cancer incidence in World Trade Center rescue and recovery workers by race and ethnicity.

It is unclear whether differences in health outcomes by racial and ethnic groups among World Trade Center (WTC) rescue and recovery workers reflect those of the population of New York State (NYS) or show distinct patterns. We assessed cancer incidence in WTC workers by self-reported race and ethnicity, and compared it to population figures for NYS. A total of 61,031 WTC workers enrolled between September 11, 2001andJanuary 10, 2012were followed to December 31, 2015. To evaluate the association between race/ethnicity and cancer risk, Poissonregression analysis was used to estimate hazard ratios (HR) adjusted for WTC exposure, age, calendar year, sex and, for lung cancer, cigarette smoking. In comparison to Whites, Black workers had a higher incidence of prostate cancer (HR = 1.99, 95% CI = 1.69-2.34) and multiple myeloma (HR = 3.57, 95%CI = 1.97-6.45), and a lower incidence of thyroid (HR = 0.41, 95%CI = 0.22-0.78) and colorectal cancer (HR = 0.57; 95%CI = 0.33-0.98). Hispanic workers had a higher incidence of liver cancer (HR = 4.03, 95%CI = 2.23-7.28). Compared with NYS population, White workers had significantly higher incidence of prostate cancer (HR = 1.26, 95%CI = 1.18-1.35) and thyroid cancer (HR = 1.80, 95%CI = 1.55-2.08), while Black workers had significantly higher incidence of prostate cancer (HR = 1.22, 95%CI = 1.05-1.40). Cancer incidence in WTC workers generally reflects data from the NYS population, but some differences were identified that merit further investigation.

Recent advances in the treatment and prevention of peripheral neuropathy after multiple myeloma treatment.

The incidence of multiple myeloma (MM) is increasing year by year, requiring chemotherapy drugs to control the condition. With the advent of new proteasome inhibitors, immunomodulators, and monoclonal antibodies, the prognosis of patients has improved significantly. However, peripheral neuropathy caused by drugs limits the dose and duration of treatment, which seriously affects patients' quality of life and treatment outcome. Although the neuropathies induced by chemotherapy drugs have attracted much attention, their mechanism and effective prevention and treatment measures are not clear. Therefore, how to alleviate peripheral neuropathy caused by drugs for treatment of MM is a key issue in improving patients' quality of life and prolonging their survival time, which have some clinical value. In this paper, we review the current research on the pathogenesis, pharmacological and nonpharmacological treatment, and prevention, which expects to present instruction for peripheral neuropathy after treatment of MM.

Ethnic disparities in presentation but not outcome in multiple myeloma patients: a multicenter retrospective study in Northern Israel

Several studies showed ethnic disparities in multiple myeloma (MM) incidence and prognosis. In order to compare prognosis and overall survival between different ethnic groups, a multicenter retrospective study was conducted in Northern Israel. A total of 145 patients suffering from MM were included (72% Jewish, and 28% Arabs) who were treated between 2008–2018. A difference was found in the stage of the disease at the time of diagnosis, patients of Arab origin were diagnosed at a more advanced stage (III), (53.7% vs. 33.7%, respectively). A mortality rate of 48.9% was found in the study, regardless of population ethnic origin. No significant differences in rates of MGUS, MM symptoms, treatments, or progression-free survival (PFS) and overall survival (OS) were observed between ethnic groups. This suggests that raising awareness of MM may result in an earlier diagnosis, especially among patients of Arab origin, preventing unnecessary suffering from these patients.

Further analysis of incidence of multiple myeloma among atomic-bomb survivors, 1950 to 1994.

Multiple myeloma (MM) predominantly occurs in older persons and its diagnosis depends on pathological and laboratory findings. Epidemiological studies have provided inconsistent results on relationship between radiation exposure and MM. The Life Span Study (LSS) of atomic bomb (A-bomb) survivors has not shown a statistically significant radiation risk for MM. We studied previously reported MM cases diagnosed between 1950 and 1994 in the LSS and assessed diagnostic certainty based on histological and clinical features. Among 122 incident MM cases, 67 were classified as definite, 23, probable and 32, undetermined. The incidence rate increased with attained age and was highest in the oldest age group of over 70 years. For definite MM, Poisson regression dose response analysis showed an elevated, though not statistically significant, radiation risk with an estimated excess relative risk (ERR) per Gy of 0.44 (95%CI:<-0.02, 2.4), which was markedly higher than the previously reported ERR/Gy of -0.02 (95% CI: -0.24,0.75) that included cases with undetermined diagnostic certainty. The present case series included 24 persons with MM diagnosed after participating in M-protein screening offered to a clinical subset of the LSS members. Exclusion of screen-detected cases led to a higher radiation risk estimate, which was not statistically significant. A large number of young survivors exposed before age 20 years were younger than 70 years in the current follow-up period, but will reach ages with rapidly increasing MM rates. Future follow-up data with improved diagnostic certainty will improve understanding of long-term effects of radiation exposure on MM in this cohort.

Association between type 2 diabetes mellitus and multiple myeloma: Fact or fiction

Multiple myeloma is a plasma cell cancer causing bone and marrow damage, resulting in hypercalcemia, anemia, and renal insufficiency. Diabetes mellitus occurs in 6-24% of multiple myeloma cases, associated with immunosuppression, inflammation, and lymphocyte dysfunction, possibly contributing to multiple myeloma development. Insulin and insulin-like growth factor-1 also contribute to multiple myeloma pathogenesis. The incidence of both multiple myeloma and diabetes mellitus is expected to rise due to the aging population, lifestyle changes, genetic predisposition, and improved diagnostic methods. Although the link between diabetes mellitus and hematological malignancy risk is less conclusive, insulin resistance and growth factors may promote tumor cell proliferation. Genetic variants linked to type 2 diabetes mellitus (T2DM) influence multiple myeloma risks. The insulin like growth factor 1 (IGF1) gene triggers malignant plasma cell proliferation. Additionally, poorly managed T2DM-induced acidosis creates a favorable environment for cancer cell growth, including multiple myeloma. T2DM and metabolic syndrome (MetS) increase multiple myeloma risks through insulin resistance, hyperinsulinemia, inflammation, and dyslipidemia. Inflammatory cytokines [interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), and interleukin-1β (IL-1β)] contribute to insulin resistance, chronic inflammation, and multiple myeloma cell survival too. The coexistence of diabetes and multiple myeloma presents challenges in managing complications like neuropathy, nephropathy, and retinopathy. In conclusion, the association between T2DM and multiple myeloma has been established, with a discernible influence from distinct genetic variations. Notably, IL-6, TNF-alpha, and IL-1β exert significant influence on the development of insulin resistance and the proliferation of cancer cells, and also their viability. Consequently, the involvement of inflammatory cytokines, dyslipidemia, and IGF1 in the progression of MM among patients with T2DM and MetS is noteworthy.

Racial bias in multiple myeloma clinical trials: Racial minorities continue to miss out on treatment advances.

e20009 Background: Adequate representation of participants based on race and ethnicity in a clinical trial helps ensure the results' generalizability. There is a disparity in the participation of minorities in oncology clinical trials despite higher incidence and disease burden in them. The incidence of Multiple Myeloma (MM) in AA (African American) is twice as compared to White, and they are twice as likely to die from MM compared to White. Methods: We queried ClinicalTrials.gov in February 2023 for all completed interventional trials with the published results for Multiple Myeloma in the US. Demographic data were collected from all the studies. If not available, the primary manuscript was searched using the trial number. We excluded the studies involving other malignancies and conducted outside of the USA. Trials on prevention, diagnostics, supportive care, and antibiotics were also excluded. Incidence data of Multiple myeloma was obtained from the SEER database for each ethnicity and race. Results: Out of 194 trials included in our study, 133 (68.56%) reported at least either race or ethnicity. Of these trials, 83 (42.78) reported race, 124 (63.91) reported ethnicity, and 77 (39.69) reported both race and ethnicity. 5.67% of the trial participants were reported as Hispanic race. White, AA, and Asian represented 79.82%, 11.36%, and 3.10% of the trial participants, respectively. The number of trials reporting race or ethnicity has increased when comparing the trials conducted between 2001-2011 and 2012-2022 (58.3% vs. 90.3%); OR 6.4; 95% CI 2.77-17.98; p&lt;0.001. Participation of Asians increased (2% vs. 5.5%; p&lt;0.0005), while there were slight changes among AA (11.7% vs. 10.6%, p=0.1475), Hispanic (5.4% vs. 6%; p=0.3863), and White (80.8% vs. 77.8%, p=0.208) between 2001-2011 and 2012-2022. Conclusions: Despite ongoing efforts to improve the diversity of minorities in oncology trials, they are still under-enrolled in multiple myeloma. More studies and interventions are needed to address this disparity. [Table: see text]

Identifying associations between race and gender in the incidence and mortality of patients with multiple myeloma.

e20052 Background: Multiple Myeloma (MM) is a plasma cell malignancy due to proliferation of malignant clonal plasma cells. Prior studies have shown that overall incidence of MM was 8.47 per 100,000 individuals. It has also been seen that the incidence of MM has trended upwards in non-Hispanic white (NHW) males and non-Hispanic blacks (NHB) across all age groups. This retrospective, database-driven population study sought to further assess racial and gender-based differences in the trends of the incidence of MM and mortality from MM. Methods: Data obtained from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) registry 17 were available to assess trends of multiple myeloma incidence and mortality from 2000 to 2019. Trends were described as average annual percentage change (APC) rates. Results: A total of 102,467 MM patients were identified in this data set; 56,508 (55.1%) were males and 45,949 (44.8%) were female. The distribution of MM by race was as follows (in order from highest to lowest): Non-Hispanic White [NHW] patients was 63.2% (N = 64,776), Non-Hispanic Black [NHB] patients was 18.6% (n = 19,099), Hispanic patients was 11.6 % (11,841), Non-Hispanic Asian [NHA] patients was 5.6% (5,769), and Non-Hispanic American Indian [NHAI]/Alaska Native patients was 0.5% (523). Incidence of MM (cases per 100,000 persons) was highest in males (7.5; 95% CI: 7.5, 7.6) and blacks (13; 95% CI: 12.8, 13.2). Overall trend in the incidence of MM has increased significantly for all gender and ethnicity groups over the period from 2000-2019, except for NHA patients. The incidence-based mortality of MM was highest in male (5.2; 95% CI: 5.2, 5.3) and black (8.7; 95% CI: 8.5, 8.8) patients. The overall incidence-based mortality increased significantly in males APC 4.1% (95% CI: 2.2,5.9; p &lt; 0.001), females APC 3.6% (95% CI, 1.8,5.5; p &lt; 0.001) and all ethnicities - NHW patients APC 4.1%, (95% CI, 2.2,6.0; p &lt; 0.001), NHB (APC 4.2%, 95% CI, 2.1,6.3; P &lt; 0.001), NHAI (APC 4.7%, 95% CI, -2.2,7.2; p &lt; 0.001), NHA (APC 3.0%, 95% CI: 0.8,5.2; P = 0.009) and Hispanic (APC 2.9, 95% CI:1.1,4.7; P = 0.003). Conclusions: Population-based trends in MM incidence and mortality, as reported in this study, were increased commensurate with prior reports. Of note, mortality was noted to be highest amongst the NHB and male populations, indicating a need for further research focused efforts in this potentially high-risk population.

Association of serum 25-hydroxyvitamin D with the incidence of 16 cancers, cancer mortality, and all-cause mortality among individuals with metabolic syndrome: a prospective cohort study.

The relationship between vitamin D levels and cancer incidence and mortality in individuals with metabolic syndrome (MetS) remains poorly explored. Herein, we aimed to determine the association between 25-hydroxyvitamin D [25(OH)D] concentrations and the risk of 16 cancer incidence types and cancer/all-cause mortality in patients with MetS. We enrolled 97,621 participants with MetS at recruitment from the UK Biobank cohort. The exposure factor was baseline serum 25(OH)D concentrations. The associations were examined using Cox proportional hazards models, which were displayed as hazard ratios (HRs) with 95% confidence intervals (CIs). Over a median follow-up period of 10.92years for cancer incidence outcomes, 12,137 new cancer cases were recorded. We observed that 25(OH)D concentrations were inversely related to the risk of colon, lung, and kidney cancer, and HRs (95% CI) for 25(OH)D ≥ 75.0 vs. < 25.0nmol/L were 0.67 (0.45-0.98), 0.64 (0.45-0.91), and 0.54 (0.31-0.95), respectively. The fully adjusted model revealed a null correlation between 25(OH)D and the incidence of stomach, rectum, liver, pancreas, breast, ovary, bladder, brain, multiple myeloma, leukemia, non-Hodgkin lymphoma, esophagus, and corpus uteri cancer. Over a median follow-up period of 12.72years for mortality outcomes, 8286 fatalities (including 3210 cancer mortalities) were documented. An "L-shaped" nonlinear dose-response correlation was detected between 25(OH)D and cancer/all-cause mortality; the respective HRs (95% CI) were 0.75 (0.64-0.89) and 0.65 (0.58-0.72). These findings emphasize the importance of 25(OH)D in cancer prevention and longevity promotion among patients with MetS.

Systematic Review and Meta-Analysis of the Impact of Bariatric Surgery on Future Cancer Risk.

The study aimed to perform a systematic review and meta-analysis of the evidence for the prevention of future cancers following bariatric surgery. A systematic literature search of the Cochrane Library, Embase, Scopus, Web of Science and PubMed databases (2007-2023), Google Scholar and grey literature was conducted. A meta-analysis was performed using the inverse variance method and random effects model. Thirty-two studies involving patients with obesity who received bariatric surgery and control patients who were managed with conventional treatment were included. The meta-analysis suggested bariatric surgery was associated with a reduced overall incidence of cancer (RR 0.62, 95% CI 0.46-0.84, p < 0.002), obesity-related cancer (RR 0.59, 95% CI 0.39-0.90, p = 0.01) and cancer-associated mortality (RR 0.51, 95% CI 0.42-0.62, p < 0.00001). In specific cancers, bariatric surgery was associated with reduction in the future incidence of hepatocellular carcinoma (RR 0.35, 95% CI 0.22-0.55, p < 0.00001), colorectal cancer (RR 0.63, CI 0.50-0.81, p = 0.0002), pancreatic cancer (RR 0.52, 95% CI 0.29-0.93, p = 0.03) and gallbladder cancer (RR 0.41, 95% CI 0.18-0.96, p = 0.04), as well as female specific cancers, including breast cancer (RR 0.56, 95% CI 0.44-0.71, p < 0.00001), endometrial cancer (RR 0.38, 95% CI 0.26-0.55, p < 0.00001) and ovarian cancer (RR 0.45, 95% CI 0.31-0.64, p < 0.0001). There was no significant reduction in the incidence of oesophageal, gastric, thyroid, kidney, prostate cancer or multiple myeloma after bariatric surgery as compared to patients with morbid obesity who did not have bariatric surgery. Obesity-associated carcinogenesis is closely related to metabolic syndrome; visceral adipose dysfunction; aromatase activity and detrimental cytokine, adipokine and exosomal miRNA release. Bariatric surgery results in long-term weight loss in morbidly obese patients and improves metabolic syndrome. Bariatric surgery may decrease future overall cancer incidence and mortality, including the incidence of seven obesity-related cancers.