1
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Akkus E, Tuncalı T, Akın HY, Aydın Y, Beşışık SK, Gürkan E, Ratip S, Salihoğlu A, Sargın D, Ünal A, Turcan A, Sevindik ÖG, Demir M, Beksac M. Germline genetic variants in Turkish familial multiple myeloma/monoclonal gammopathy of undetermined significance cases. Br J Haematol 2024; 204:931-938. [PMID: 38115798 DOI: 10.1111/bjh.19271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/27/2023] [Accepted: 12/09/2023] [Indexed: 12/21/2023]
Abstract
Multiple myeloma (MM) is a haematological malignancy primarily affecting the elderly, with a striking male predilection and ethnic disparities in incidence. Familial predisposition to MM has long been recognized, but the genetic underpinnings remain elusive. This study aimed to investigate germline variants in Turkish families with recurrent MM cases. A total of 37 MM-affected families, comprising 77 individuals, were included. Targeted next-generation sequencing analysis yielded no previously reported rare variants. Whole exome sequencing analysis in 11 families identified rare disease-causing variants in various genes, some previously linked to familial MM and others not previously associated. Notably, genes involved in ubiquitination, V(D)J recombination and the PI3K/AKT/mTOR pathway were among those identified. Furthermore, a specific variant in BNIP1 (rs28199) was found in 13 patients across nine families, indicating its potential significance in MM pathogenesis. While this study sheds light on genetic variations in familial MM in Turkey, its limitations include sample size and the absence of in vivo investigations. In conclusion, familial MM likely involves a polygenic inheritance pattern with rare, disease-causing variants in various genes, emphasizing the need for international collaborative efforts to unravel the intricate genetic basis of MM and develop targeted therapies.
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Affiliation(s)
- Erman Akkus
- Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Timur Tuncalı
- Department of Medical Genetics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Hasan Yalım Akın
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Yıldız Aydın
- Department of Hematology, Florence Nightingale Hospitals, Istanbul, Turkey
| | - Sevgi Kalayoğlu Beşışık
- Department of Internal Medicine, Division of Hematology, Istanbul University Medical Faculty, Istanbul, Turkey
| | - Emel Gürkan
- Department of Hematology, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Siret Ratip
- Department of Hematology, Acibadem Healthcare Group, Istanbul, Turkey
| | - Ayşe Salihoğlu
- Department of Hematology, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Deniz Sargın
- Department of Hematology, Medipol University Faculty of Medicine, İstanbul, Turkey
| | - Ali Ünal
- Department of Hematology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | | | - Ömür Gökmen Sevindik
- Department of Hematology, Medipol University Faculty of Medicine, İstanbul, Turkey
| | - Muzaffer Demir
- Department of Hematology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Meral Beksac
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
- Department of Hematology, Ankara Liv Hospital, Istinye University, Ankara, Turkey
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2
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Bhutani M, Blue BJ, Cole C, Badros AZ, Usmani SZ, Nooka AK, Bernal-Mizrachi L, Mikhael J. Addressing the disparities: the approach to the African American patient with multiple myeloma. Blood Cancer J 2023; 13:189. [PMID: 38110338 PMCID: PMC10728116 DOI: 10.1038/s41408-023-00961-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/20/2023] Open
Abstract
There are significant disparities with regards to incidence, timely diagnosis, access to treatment, clinical trial participation and health care utilization that negatively impact outcomes for African American patients with multiple myeloma. Health care providers have a role in ameliorating these disparities with thoughtful consideration of historical, sociocultural, individual and disease characteristics that influence the care provided to African American patient population. This review by a group of experts committed to health disparity in multiple myeloma provides a snapshot of disparities at both biologic and non-biologic levels, barriers to clinical care, and best practices to ensure that African American patients receive the best care available.
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Affiliation(s)
- Manisha Bhutani
- Department of Hematologic Oncology and Blood Disorders, Atrium Health Levine Cancer Institute/Wake Forest School of Medicine, Charlotte, NC, USA.
| | - Brandon J Blue
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Craig Cole
- Division of Hematology and Oncology, Michigan State University, College of Human Medicine/Karmanos Cancer Institute at McLaren Greater Lansing, Lansing, MI, USA
| | - Ashraf Z Badros
- Department of Medicine, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Saad Z Usmani
- Multiple Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ajay K Nooka
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Leon Bernal-Mizrachi
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Joseph Mikhael
- Translational Genomics Research Institute, City of Hope Cancer Center, Phoenix, AZ, USA
- International Myeloma Foundation, Studio City, CA, USA
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3
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Dumontet C, Demangel D, Galia P, Karlin L, Roche L, Fauvernier M, Golfier C, Laude M, Leleu X, Rodon P, Roussel M, Azaïs I, Doyen C, Slama B, Manier S, Decaux O, Pertesi M, Beaumont M, Caillot D, Boyle EM, Cliquennois M, Cony‐Makhoul P, Doncker A, Dorvaux V, Petillon MO, Fontan J, Hivert B, Leduc I, Leyronnas C, Macro M, Maigre M, Mariette C, Mineur P, Rigaudeau S, Royer B, Vincent L, Mckay J, Perrial E, Garderet L. Clinical characteristics and outcome of 318 families with familial monoclonal gammopathy: A multicenter Intergroupe Francophone du Myélome study. Am J Hematol 2023; 98:264-271. [PMID: 36588407 PMCID: PMC10107808 DOI: 10.1002/ajh.26785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 10/10/2022] [Accepted: 10/24/2022] [Indexed: 01/03/2023]
Abstract
Familial forms of monoclonal gammopathy, defined as multiple myeloma (MM) or Monoclonal Gammopathy of Undetermined Significance (MGUS), are relatively infrequent and most series reported in the literature describe a limited number of families. MM rarely occurs in a familial context. MGUS is observed much more commonly, which can in some cases evolve toward full-blown MM. Although recurrent cytogenetic abnormalities have been described in tumor cells of sporadic cases of MM, the pathogenesis of familial MM remains largely unexplained. In order to identify genetic factors predisposing to familial monoclonal gammopathy, the Intergroupe Francophone du Myélome identified 318 families with at least two confirmed cases of monoclonal gammopathy. There were 169 families with parent/child pairs and 164 families with cases in at least two siblings, compatible with an autosomal transmission. These familial cases were compared with sporadic cases who were matched for age at diagnosis, sex and immunoglobulin isotype, with 10 sporadic cases for each familial case. The gender distribution, age and immunoglobulin subtypes of familial cases were unremarkable in comparison to sporadic cases. With a median follow-up of 7.4 years after diagnosis, the percentage of MGUS cases having evolved to MM was 3%. The median overall survival of the 148 familial MM cases was longer than that of matched sporadic cases, with projected values of 7.6 and 16.1 years in patients older and younger than 65 years, respectively. These data suggest that familial cases of monoclonal gammopathy are similar to sporadic cases in terms of clinical presentation and carry a better prognosis.
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Affiliation(s)
- Charles Dumontet
- Hospices Civils de LyonLyonFrance
- CRCL, UMR INSERM 1052/CNRS 5286/University of Lyon‐FranceLyonFrance
| | | | | | | | | | | | | | | | | | | | | | | | | | - Borhane Slama
- Clinical Hematology DepartmentCH AvignonAvignonFrance
| | | | - Olivier Decaux
- Hematology DepartmentCHU Rennes, Inserm UMR1236RennesFrance
| | - Maroulio Pertesi
- Genetic Cancer Susceptibility, International Agency for Research on CancerLyonFrance
- Department of Laboratory MedicineHematology and Transfusion MedicineLundSweden
| | | | - Denis Caillot
- Clinical Hematology DepartmentHôpital F. Mitterrand, CHU DijonDijonFrance
| | - Eileen M. Boyle
- Perlmutter Cancer CenterNYU Langone HealthNew YorkNew YorkUSA
| | | | | | | | - Véronique Dorvaux
- Clinical Hematology DepartmentCHR Metz‐ThionvilleMetz‐ThionvilleFrance
| | | | - Jean Fontan
- Hematology DepartmentCHU BesançonBesançonFrance
| | | | | | | | | | - Michel Maigre
- Internal Medicine DepartmentCH ChartresChartresFrance
| | | | - Philippe Mineur
- Clinical Hematology DepartmentGrand Hôpital de CharleroiCharleroiBelgium
| | | | - Bruno Royer
- Clinical Hematology and Cell Therapy DepartmentAmiensFrance
| | | | - James Mckay
- Genetic Cancer Susceptibility, International Agency for Research on CancerLyonFrance
| | - Emeline Perrial
- CRCL, UMR INSERM 1052/CNRS 5286/University of Lyon‐FranceLyonFrance
| | - Laurent Garderet
- HU PITIE SALPETRIERE APHPParisFrance
- Centre de Recherche Saint‐Antoine‐Team Hematopoietic and Leukemic DevelopmentSorbonne Université‐INSERM, UMR_S 938ParisFrance
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4
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Langseth ØO, Myklebust TÅ, Johannesen TB, Hjertner Ø, Waage A. Risk of multiple myeloma and other malignancies among first- and second-degree relatives of patients with multiple myeloma: A population-based study. Eur J Haematol Suppl 2022; 108:486-492. [PMID: 35184337 PMCID: PMC9310738 DOI: 10.1111/ejh.13757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 01/05/2023]
Abstract
Objectives We conducted a population‐based study to assess the risk for multiple myeloma (MM) and other cancers in first‐ and second‐degree relatives of MM patients, and to investigate whether evidence of anticipation is present in familial MM. Methods We retrieved 24 845 first‐degree relatives and 41 008 second‐degree relatives of 7847 MM patients, and 86 984 first‐degree relatives, and 138 660 second‐degree relatives of 26 511 matched controls. A Cox model was used to assess the risk for MM and other cancers in relatives of MM patients. Anticipation was assessed by a Cox model, where all parents and offspring of MM patients were included in the risk set. Results In second‐degree relatives of MM patients, no overall significant association with an MM diagnosis was observed (HR 1.99; 95%CI:0.86–4.57). In parents and offspring of MM patients, we found no significant difference in the ages at onset of MM (HR 1.28;95% CI:0.50–3.28). In affected parent‐offspring pairs, we observed no statistically significant difference in overall survival between the generations (HR 0.74; 95%CI:0.20–2.69). Conclusions Overall, second‐degree relatives of MM patients were not associated with an increased risk for MM. Our study supports that genetic anticipation is not present in familial MM.
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Affiliation(s)
- Øystein O Langseth
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Hematology, St. Olav's University Hospital, Trondheim, Norway
| | - Tor Å Myklebust
- Department of Registration, Cancer Registry of Norway, Oslo, Norway.,Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Tom B Johannesen
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Øyvind Hjertner
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Hematology, St. Olav's University Hospital, Trondheim, Norway
| | - Anders Waage
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Hematology, St. Olav's University Hospital, Trondheim, Norway
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5
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Sigurbergsdóttir AÝ, Love TJ, Kristinsson SY. Autoimmunity, Infections, and the Risk of Monoclonal Gammopathy of Undetermined Significance. Front Immunol 2022; 13:876271. [PMID: 35572590 PMCID: PMC9096784 DOI: 10.3389/fimmu.2022.876271] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Various epidemiological studies, including case reports and -series in addition to larger, population-based studies, have reported an increased prevalence of monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma in individuals with a prior history of immune-related conditions. This is believed to support the role of chronic antigen stimulation in the pathogenesis of these conditions. In this short review, we summarize some of the largest population-based studies researching autoimmune diseases, infections, and the subsequent risk of MGUS, and discuss our understanding on its etiology and pathogenesis. Furthermore, we highlight important methodological limitations of previous studies in the field, but almost all studies on MGUS have been based on clinical, possibly biased, cohorts. Finally, we discuss future directions in researching the associations of MGUS and other disorders, including immune-related conditions, where screening studies play an important role.
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Affiliation(s)
| | - Thorvardur Jon Love
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Science and Research, Landspitali University Hospital, Reykjavik, Iceland
| | - Sigurður Yngvi Kristinsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Haematology, Landspitali University Hospital, Reykjavik, Iceland
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6
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Staron A, Verma K, Sanchorawala V. Prevalence of plasma cell and lymphoproliferative disorders among blood relatives of patients with light chain amyloidosis. Br J Haematol 2022; 198:861-865. [PMID: 35499208 DOI: 10.1111/bjh.18225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 12/01/2022]
Abstract
With limited existing data on hereditary factors in light chain (AL) amyloidosis, we conducted a study of patients with plasma cell dyscrasias or lymphoproliferative disorders in their family history. Among 1621 patients, we identified 44 probands (2·7%) with 52 relatives affected. The most common disorders in family members were multiple myeloma (48%) and AL amyloidosis (18%). Light chain isotype was 100% congruent in families with known clonal immunoglobulin for both members. Despite matching light chain isotype, organ involvement varied between members in families with multiple cases of AL amyloidosis. These findings help generate hypotheses about familial influences in AL amyloidosis.
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Affiliation(s)
- Andrew Staron
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Section of Hematology and Medical Oncology, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Karina Verma
- Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Vaishali Sanchorawala
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Section of Hematology and Medical Oncology, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
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7
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Visram A, Vachon C, Baughn LB, Larson D, Smadbeck J, Dispenzieri A, Kapoor P, Lacy MQ, Gertz MA, Buadi FK, Hayman SR, Dingli D, Kourelis T, Gonsalves W, Warsame R, Muchtar E, Leung N, Kyle RA, Rajkumar SV, Kumar S. Family history of plasma cell disorders is associated with improved survival in MGUS, multiple myeloma, and systemic AL amyloidosis. Leukemia 2022; 36:1058-1065. [PMID: 34764424 DOI: 10.1038/s41375-021-01454-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/19/2022]
Abstract
The association between familial plasma cell disorders (PCD) and prognosis in patients with MGUS, multiple myeloma (MM), and systemic light chain (AL) amyloidosis has not been well described. This study retrospectively reviewed outcomes of 25,423 patients (16,744 MGUS, 6194 MM, 2955 AL amyloidosis). Overall, 2.7% of patients reported having a family member with a PCD (defined as MGUS, MM, or AL amyloidosis). Family history was documented in 94% of MGUS, 92% of MM, and 88% of AL amyloidosis patients. The overall survival was consistently longer in patients with versus without familial PCD (crude hazard ratios: 0.52, 95% CI 0.40-0.67, p < 0.001 for MGUS patients; 0.68, 95% CI 0.57-0.79, p < 0.001 for MM patients; 0.60, 95% CI 0.43-0.84, p = 0.003 for AL patients). This association remained consistent when adjusting for baseline patient and disease characteristics. In MGUS patients, the risk of progression to MM, AL amyloidosis, or a lymphoproliferative disorder was higher in patients with familial PCD when accounting for death as a competing risk (cause-specific HR 1.9, 95% 1.3-2.7, p < 0.001). This is the first study to demonstrate that in a cohort of MGUS, MM, and systemic AL amyloidosis, patients with a PCD family history have an improved overall survival.
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Affiliation(s)
- Alissa Visram
- Division of Hematology, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Celine Vachon
- Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Linda B Baughn
- Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
- Division of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Dirk Larson
- Division of Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - James Smadbeck
- Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | | | | | - Martha Q Lacy
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Morie A Gertz
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | | | - David Dingli
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Rahma Warsame
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Eli Muchtar
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Nelson Leung
- Division of Nephrology, Mayo Clinic, Rochester, MN, USA
| | - Robert A Kyle
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Shaji Kumar
- Division of Hematology, Mayo Clinic, Rochester, MN, USA.
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8
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A genetic risk score of alleles related to MGUS interacts with socioeconomic position in a population-based cohort. Sci Rep 2022; 12:4409. [PMID: 35292679 PMCID: PMC8924237 DOI: 10.1038/s41598-022-08294-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/04/2022] [Indexed: 11/14/2022] Open
Abstract
Environmental, genetic, and social factors are suggested to jointly influence monoclonal gammopathy of undetermined significance (MGUS), a precursor of multiple myeloma. Aim of this study was to investigate interactions between MGUS-related genetic variants and socioeconomic position (SEP) indicators education and income on MGUS in a population-based study. Two different MGUS-related genetic risk allele sum scores (GRS) were calculated based on recent genome-wide meta-analyses. Odds Ratios (OR) were estimated in 4329 participants including 238 MGUS cases to assess associations and multiplicative interaction. The relative excess risk due to interaction (RERI) was calculated to assess additive interaction. Both GRSs were associated with MGUS. A multiplicative interaction between one GRS and education was observed with genetic effects of OR 1.34 (95% CI 1.11–1.62) per risk allele in the highest and OR 1.06 (95% CI 0.86–1.31) in the lowest education group. A RERI of 0.10 (95% CI 0.05–0.14) also indicated additive interaction. Further, additive GRS by income interaction (RERI 0.07; 95% CI 0.01–0.13) for the same GRS was also indicated. Results indicate interaction between MGUS-related genetic risk and SEP. Non-genetic MGUS risk factors more common in higher education groups may influence the expression of MGUS-related genetic variants.
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9
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Peres LC, Hansen DK, Maura F, Kazandjian D. The knowns and unknowns of disparities, biology, and clinical outcomes in Hispanic and Latinx multiple myeloma patients in the U.S. Semin Oncol 2022; 49:3-10. [DOI: 10.1053/j.seminoncol.2022.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 01/23/2022] [Indexed: 11/11/2022]
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10
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Metabolic Disorders in Multiple Myeloma. Int J Mol Sci 2021; 22:ijms222111430. [PMID: 34768861 PMCID: PMC8584036 DOI: 10.3390/ijms222111430] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/08/2021] [Accepted: 10/21/2021] [Indexed: 02/06/2023] Open
Abstract
Multiple myeloma (MM) is the second most common hematological malignancy and is attributed to monoclonal proliferation of plasma cells in the bone marrow. Cancer cells including myeloma cells deregulate metabolic pathways to ensure proliferation, growth, survival and avoid immune surveillance, with glycolysis and glutaminolysis being the most identified procedures involved. These disorders are considered a hallmark of cancer and the alterations performed ensure that enough energy is available for rapid cell proliferation. An association between metabolic syndrome, inflammatory cytokinesand incidence of MM has been also described, while the use of metformin and statins has been identified as a positive prognostic factor for the disease course. In this review, we aim to present the metabolic disorders that occur in multiple myeloma, the potential defects on the immune system and the potential advantage of targeting the dysregulated pathways in order to enhance antitumor therapeutics.
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11
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Hornung N, Frank M, Dragano N, Dürig J, Dührsen U, Moebus S, Erbel R, Stang A, Jöckel KH, Schmidt B. Monoclonal gammopathy of undetermined significance is associated with prostate cancer in a population-based cohort study. Sci Rep 2021; 11:19266. [PMID: 34588555 PMCID: PMC8481402 DOI: 10.1038/s41598-021-98803-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/06/2021] [Indexed: 11/30/2022] Open
Abstract
Register-based studies indicate a possible association of monoclonal gammopathy of undetermined significance (MGUS) and prostate cancer (PCa). Aim of the present study was to investigate the relationship between MGUS and PCa considering potentially shared risk factors. Data from the prospective population-based Heinz Nixdorf Recall cohort study of 2.385 men (age 45–85) were analyzed. MGUS was determined at three points in time; cases of cancer were assessed annually. Potentially shared risk factors were assessed at baseline. Hazard ratios (HR), adjusted for age and educational attainment, and corresponding 95%-confidence intervals (95%-CI) were calculated. 157 cases of MGUS and 143 incident cases of PCa were detected. Of 19 participants diagnosed with both, MGUS and incident PCa, only in one case MGUS did not clearly occur before PCa. MGUS was associated with PCa presenting a HR of 2.00 (95%-CI: 1.23–3.25). Stratified by isotype, IgM-MGUS showed the strongest association with PCa. There was no relevant change of the effect estimate when adjusting for potentially shared risk factors. We were able to give supporting evidence for an association between MGUS and PCa and pointed out its temporality. There was no indication that the observed association is due to shared risk factors. The present study indicated that different isotypes of MGUS differ in the strength of the effect on PCa-risk. Based on these findings, future studies investigating the pathophysiological background of the association will be needed.
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Affiliation(s)
- Nicola Hornung
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Mirjam Frank
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Nico Dragano
- Department of Medical Sociology, University Clinic Düsseldorf, Düsseldorf, Germany
| | - Jan Dürig
- Department of Hematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulrich Dührsen
- Department of Hematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany.
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12
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Hemminki K, Försti A, Houlston R, Sud A. Epidemiology, genetics and treatment of multiple myeloma and precursor diseases. Int J Cancer 2021; 149:1980-1996. [PMID: 34398972 DOI: 10.1002/ijc.33762] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 12/17/2022]
Abstract
Multiple myeloma (MM) is a hematological malignancy caused by the clonal expansion of plasma cells. The incidence of MM worldwide is increasing with greater than 140 000 people being diagnosed with MM per year. Whereas 5-year survival after a diagnosis of MM has improved from 28% in 1975 to 56% in 2012, the disease remains essentially incurable. In this review, we summarize our current understanding of MM including its epidemiology, genetics and biology. We will also provide an overview of MM management that has led to improvements in survival, including recent changes to diagnosis and therapies. Areas of unmet need include the management of patients with high-risk MM, those with reduced performance status and those refractory to standard therapies. Ongoing research into the biology and early detection of MM as well as the development of novel therapies, such as immunotherapies, has the potential to influence MM practice in the future.
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Affiliation(s)
- Kari Hemminki
- Biomedical Center, Faculty of Medicine, Charles University in Pilsen, Pilsen, Czech Republic.,Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Asta Försti
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Richard Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Amit Sud
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK.,The Department of Haemato-Oncology, The Royal Marsden Hospital NHS Foundation Trust, London, UK
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13
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Waller RG, Klein RJ, Vijai J, McKay JD, Clay-Gilmour A, Wei X, Madsen MJ, Sborov DW, Curtin K, Slager SL, Offit K, Vachon CM, Lipkin SM, Dumontet C, Camp NJ. Sequencing at lymphoid neoplasm susceptibility loci maps six myeloma risk genes. Hum Mol Genet 2021; 30:1142-1153. [PMID: 33751038 PMCID: PMC8188404 DOI: 10.1093/hmg/ddab066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 11/14/2022] Open
Abstract
Inherited genetic risk factors play a role in multiple myeloma (MM), yet considerable missing heritability exists. Rare risk variants at genome-wide association study (GWAS) loci are a new avenue to explore. Pleiotropy between lymphoid neoplasms (LNs) has been suggested in family history and genetic studies, but no studies have interrogated sequencing for pleiotropic genes or rare risk variants. Sequencing genetically enriched cases can help discover rarer variants. We analyzed exome sequencing in familial or early-onset MM cases to identify rare, functionally relevant variants near GWAS loci for a range of LNs. A total of 149 distinct and significant LN GWAS loci have been published. We identified six recurrent, rare, potentially deleterious variants within 5 kb of significant GWAS single nucleotide polymorphisms in 75 MM cases. Mutations were observed in BTNL2, EOMES, TNFRSF13B, IRF8, ACOXL and TSPAN32. All six genes replicated in an independent set of 255 early-onset MM or familial MM or precursor cases. Expansion of our analyses to the full length of these six genes resulted in a list of 39 rare and deleterious variants, seven of which segregated in MM families. Three genes also had significant rare variant burden in 733 sporadic MM cases compared with 935 control individuals: IRF8 (P = 1.0 × 10-6), EOMES (P = 6.0 × 10-6) and BTNL2 (P = 2.1 × 10-3). Together, our results implicate six genes in MM risk, provide support for genetic pleiotropy between LN subtypes and demonstrate the utility of sequencing genetically enriched cases to identify functionally relevant variants near GWAS loci.
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MESH Headings
- Acyl-CoA Oxidase/genetics
- Butyrophilins/genetics
- Female
- Genetic Predisposition to Disease
- Genome-Wide Association Study
- Hodgkin Disease/genetics
- Hodgkin Disease/pathology
- Humans
- Interferon Regulatory Factors/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymphocytes/pathology
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/pathology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Multiple Myeloma/genetics
- Multiple Myeloma/pathology
- Polymorphism, Single Nucleotide/genetics
- Risk Factors
- T-Box Domain Proteins/genetics
- Tetraspanins/genetics
- Transmembrane Activator and CAML Interactor Protein/genetics
- Exome Sequencing
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Affiliation(s)
| | - Robert J Klein
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, Icahn Institute for Data Science and Genomic Technology, New York, NY 10029-5674, USA
| | - Joseph Vijai
- Department of Medicine, Clinical Genetics Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - James D McKay
- Genetic Cancer Susceptibility, International Agency for Research on Cancer, 69372 Lyon Cedex 08, France
| | - Alyssa Clay-Gilmour
- Department of Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN 55905, USA
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Xiaomu Wei
- Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - Michael J Madsen
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Douglas W Sborov
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Karen Curtin
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Susan L Slager
- Department of Health Sciences, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 55905, USA
| | - Kenneth Offit
- Department of Medicine, Clinical Genetics Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - Celine M Vachon
- Department of Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN 55905, USA
| | - Steven M Lipkin
- Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - Charles Dumontet
- INSERM 1052, CNRS 5286, University of Lyon, 69361 Lyon Cedex 07, France
| | - Nicola J Camp
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
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14
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Griffin Waller R, Madsen MJ, Gardner J, Sborov DW, Camp NJ. Duo Shared Genomic Segment analysis identifies a genome-wide significant risk locus at 18q21.33 in myeloma pedigrees. JOURNAL OF TRANSLATIONAL GENETICS AND GENOMICS 2021; 5:112-123. [PMID: 34888494 PMCID: PMC8654160 DOI: 10.20517/jtgg.2021.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM High-risk pedigrees (HRPs) are a powerful design to map highly penetrant risk genes. We previously described Shared Genomic Segment (SGS) analysis, a mapping method for single large extended pedigrees that also addresses genetic heterogeneity inherent in complex diseases. SGS identifies shared segregating chromosomal regions that may inherit in only a subset of cases. However, single large pedigrees that are individually powerful (at least 15 meioses between studied cases) are scarce. Here, we expand the SGS strategy to incorporate evidence from two extended HRPs by identifying the same segregating risk locus in both pedigrees and allowing for some relaxation in the size of each HRP. METHODS Duo-SGS is a procedure to combine single-pedigree SGS evidence. It implements statistically rigorous duo-pedigree thresholding to determine genome-wide significance levels that account for optimization across pedigree pairs. Single-pedigree SGS identifies optimal segments shared by case subsets at each locus across the genome, with nominal significance assessed empirically. Duo-SGS combines the statistical evidence for SGS segments at the same genomic location in two pedigrees using Fisher's method. One pedigree is paired with all others and the best duo-SGS evidence at each locus across the genome is established. Genome-wide significance thresholds are determined through distribution-fitting and the Theory of Large Deviations. We applied the duoSGS strategy to eleven extended, myeloma HRPs. RESULTS We identified one genome-wide significant region at 18q21.33 (0.85 Mb, P = 7.3 × 10-9) which contains one gene, CDH20. Thirteen regions were genome-wide suggestive: 1q42.2, 2p16.1, 3p25.2, 5q21.3, 5q31.1, 6q16.1, 6q26, 7q11.23, 12q24.31, 13q13.3, 18p11.22, 18q22.3 and 19p13.12. CONCLUSION Our results provide novel risk loci with segregating evidence from multiple HRPs and offer compelling targets and specific segment carriers to focus a future search for functional variants involved in inherited risk formyeloma.
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Affiliation(s)
- Rosalie Griffin Waller
- Huntsman Cancer Institute, Salt Lake City, UT 84112, USA
- University of Utah School of Medicine, Salt Lake City, UT 84112, USA
- Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA
| | | | - John Gardner
- Huntsman Cancer Institute, Salt Lake City, UT 84112, USA
| | - Douglas W. Sborov
- Huntsman Cancer Institute, Salt Lake City, UT 84112, USA
- University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | - Nicola J. Camp
- Huntsman Cancer Institute, Salt Lake City, UT 84112, USA
- University of Utah School of Medicine, Salt Lake City, UT 84112, USA
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15
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A meta-analysis of genome-wide association studies of multiple myeloma among men and women of African ancestry. Blood Adv 2021; 4:181-190. [PMID: 31935283 DOI: 10.1182/bloodadvances.2019000491] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/07/2019] [Indexed: 02/07/2023] Open
Abstract
Persons of African ancestry (AA) have a twofold higher risk for multiple myeloma (MM) compared with persons of European ancestry (EA). Genome-wide association studies (GWASs) support a genetic contribution to MM etiology in individuals of EA. Little is known about genetic risk factors for MM in individuals of AA. We performed a meta-analysis of 2 GWASs of MM in 1813 cases and 8871 controls and conducted an admixture mapping scan to identify risk alleles. We fine-mapped the 23 known susceptibility loci to find markers that could better capture MM risk in individuals of AA and constructed a polygenic risk score (PRS) to assess the aggregated effect of known MM risk alleles. In GWAS meta-analysis, we identified 2 suggestive novel loci located at 9p24.3 and 9p13.1 at P < 1 × 10-6; however, no genome-wide significant association was noted. In admixture mapping, we observed a genome-wide significant inverse association between local AA at 2p24.1-23.1 and MM risk in AA individuals. Of the 23 known EA risk variants, 20 showed directional consistency, and 9 replicated at P < .05 in AA individuals. In 8 regions, we identified markers that better capture MM risk in persons with AA. AA individuals with a PRS in the top 10% had a 1.82-fold (95% confidence interval, 1.56-2.11) increased MM risk compared with those with average risk (25%-75%). The strongest functional association was between the risk allele for variant rs56219066 at 5q15 and lower ELL2 expression (P = 5.1 × 10-12). Our study shows that common genetic variation contributes to MM risk in individuals with AA.
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16
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Coinherited genetics of multiple myeloma and its precursor, monoclonal gammopathy of undetermined significance. Blood Adv 2021; 4:2789-2797. [PMID: 32569378 DOI: 10.1182/bloodadvances.2020001435] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 04/22/2020] [Indexed: 12/28/2022] Open
Abstract
So far, 23 germline susceptibility loci have been associated with multiple myeloma (MM) risk. It is unclear whether the genetic variation associated with MM susceptibility also predisposes to its precursor, monoclonal gammopathy of undetermined significance (MGUS). Leveraging 2434 MM cases, 754 MGUS cases, and 2 independent sets of controls (2567/879), we investigated potential shared genetic susceptibility of MM and MGUS by (1) performing MM and MGUS genome-wide association studies (GWAS); (2) validating the association of a polygenic risk score (PRS) based on 23 established MM loci (MM-PRS) with risk of MM, and for the first time with MGUS; and (3) examining genetic correlation of MM and MGUS. Heritability and genetic estimates yielded 17% (standard error [SE] ±0.04) and 15% (SE ±0.11) for MM and MGUS risk, respectively, and a 55% (SE ±0.30) genetic correlation. The MM-PRS was associated with risk of MM when assessed continuously (odds ratio [OR], 1.17 per SD; 95% confidence interval [CI], 1.13-1.21) or categorically (OR, 1.70; 95% CI, 1.38-2.09 for highest; OR, 0.71; 95% CI, 0.55-0.90 for lowest compared with middle quintile). The MM-PRS was similarly associated with MGUS (OR, 1.19 per SD; 95% CI, 1.14-1.26 as a continuous measure, OR, 1.77, 95%CI: 1.29-2.43 for highest and OR, 0.70, 95%CI: 0.50-0.98 for lowest compared with middle quintile). MM and MGUS associations did not differ by age, sex, or MM immunoglobulin isotype. We validated a 23-SNP MM-PRS in an independent series of MM cases and provide evidence for its association with MGUS. Our results suggest shared common genetic susceptibility to MM and MGUS.
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17
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Nassar S, Taher A, Spear R, Wang F, Madewell JE, Mujtaba B. Multiple Myeloma: Role of Imaging in Diagnosis, Staging, and Treatment Response Assessment. Semin Ultrasound CT MR 2020; 42:184-193. [PMID: 33814104 DOI: 10.1053/j.sult.2020.08.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Multiple myeloma is a common hematologic malignancy of plasma cells. Differentiating multiple myeloma from the precursor stages of monoclonal gammopathy of undetermined significance and smoldering multiple myeloma is very important because the treatment approach is different for each. The diagnosis is mainly clinical, while the role of imaging is confined to the staging process, assessing response to therapy, and monitoring for disease progression. In this article, we examine the role of different imaging modalities in patients with multiple myeloma.
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Affiliation(s)
- Sameh Nassar
- Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ahmed Taher
- Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Rosario Spear
- Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - John E Madewell
- Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Bilal Mujtaba
- Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX.
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18
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Pertesi M, Went M, Hansson M, Hemminki K, Houlston RS, Nilsson B. Genetic predisposition for multiple myeloma. Leukemia 2020; 34:697-708. [PMID: 31913320 DOI: 10.1038/s41375-019-0703-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 12/24/2019] [Indexed: 12/14/2022]
Abstract
Multiple myeloma (MM) is the second most common blood malignancy. Epidemiological family studies going back to the 1920s have provided evidence for familial aggregation, suggesting a subset of cases have an inherited genetic background. Recently, studies aimed at explaining this phenomenon have begun to provide direct evidence for genetic predisposition to MM. Genome-wide association studies have identified common risk alleles at 24 independent loci. Sequencing studies of familial cases and kindreds have begun to identify promising candidate genes where variants with strong effects on MM risk might reside. Finally, functional studies are starting to give insight into how identified risk alleles promote the development of MM. Here, we review recent findings in MM predisposition field, and highlight open questions and future directions.
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Affiliation(s)
- Maroulio Pertesi
- Hematology and Transfusion Medicine, Department of Laboratory Medicine, BMC B13, 221 84, Lund, Sweden
| | - Molly Went
- Division of Genetics and Epidemiology, The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey, SM2 5NG, UK
| | - Markus Hansson
- Hematology and Transfusion Medicine, Department of Laboratory Medicine, BMC B13, 221 84, Lund, Sweden
| | - Kari Hemminki
- Department of Cancer Epidemiology, German Cancer Research Center, Im Neuenheimer Feld, Heidelberg, Germany.,Faculty of Medicine and Biomedical Center, Charles University in Prague, 30605, Pilsen, Czech Republic
| | - Richard S Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey, SM2 5NG, UK
| | - Björn Nilsson
- Hematology and Transfusion Medicine, Department of Laboratory Medicine, BMC B13, 221 84, Lund, Sweden. .,Broad Institute, 415 Main Street, Cambridge, MA, 02142, USA.
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19
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Janz S, Zhan F, Sun F, Cheng Y, Pisano M, Yang Y, Goldschmidt H, Hari P. Germline Risk Contribution to Genomic Instability in Multiple Myeloma. Front Genet 2019; 10:424. [PMID: 31139207 PMCID: PMC6518313 DOI: 10.3389/fgene.2019.00424] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 04/17/2019] [Indexed: 12/14/2022] Open
Abstract
Genomic instability, a well-established hallmark of human cancer, is also a driving force in the natural history of multiple myeloma (MM) - a difficult to treat and in most cases fatal neoplasm of immunoglobulin producing plasma cells that reside in the hematopoietic bone marrow. Long recognized manifestations of genomic instability in myeloma at the cytogenetic level include abnormal chromosome numbers (aneuploidy) caused by trisomy of odd-numbered chromosomes; recurrent oncogene-activating chromosomal translocations that involve immunoglobulin loci; and large-scale amplifications, inversions, and insertions/deletions (indels) of genetic material. Catastrophic genetic rearrangements that either shatter and illegitimately reassemble a single chromosome (chromotripsis) or lead to disordered segmental rearrangements of multiple chromosomes (chromoplexy) also occur. Genomic instability at the nucleotide level results in base substitution mutations and small indels that affect both the coding and non-coding genome. Sometimes this generates a distinctive signature of somatic mutations that can be attributed to defects in DNA repair pathways, the DNA damage response (DDR) or aberrant activity of mutator genes including members of the APOBEC family. In addition to myeloma development and progression, genomic instability promotes acquisition of drug resistance in patients with myeloma. Here we review recent findings on the genetic predisposition to myeloma, including newly identified candidate genes suggesting linkage of germline risk and compromised genomic stability control. The role of ethnic and familial risk factors for myeloma is highlighted. We address current research gaps that concern the lack of studies on the mechanism by which germline risk alleles promote genomic instability in myeloma, including the open question whether genetic modifiers of myeloma development act in tumor cells, the tumor microenvironment (TME), or in both. We conclude with a brief proposition for future research directions, which concentrate on the biological function of myeloma risk and genetic instability alleles, the potential links between the germline genome and somatic changes in myeloma, and the need to elucidate genetic modifiers in the TME.
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Affiliation(s)
- Siegfried Janz
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Fenghuang Zhan
- Department of Internal Medicine, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, United States.,Holden Comprehensive Cancer Center, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, United States
| | - Fumou Sun
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Yan Cheng
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Michael Pisano
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, United States.,Interdisciplinary Graduate Program in Immunology, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, United States
| | - Ye Yang
- The Third Affiliated Hospital, Nanjing University of Chinese Medicine, Nanjing, China.,Ministry of Education's Key Laboratory of Acupuncture and Medicine Research, Nanjing University of Chinese Medicine, Nanjing, China
| | - Hartmut Goldschmidt
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany.,Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - Parameswaran Hari
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, United States
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20
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Sverrisdóttir IS, Lund SH, Turesson I, Björkholm M, Goldin LR, Landgren O, Kristinsson SY. Parental longevity and survival among patients with multiple myeloma and monoclonal gammopathy of undetermined significance: a population-based study. Br J Haematol 2019; 186:37-44. [PMID: 30906990 DOI: 10.1111/bjh.15883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/24/2019] [Indexed: 11/29/2022]
Abstract
Parental longevity is associated with an increased life expectancy; results with regard to specific diseases are conflicting. There are limited data focusing on host characteristics and their effect on survival among multiple myeloma (MM) patients and individuals with monoclonal gammopathy of undetermined significance (MGUS). Therefore, our aim was to evaluate the impact of parental longevity on survival of patients with MM and MGUS. A total of 4675 patients with MM, 6812 MGUS patients and 13 398 population-based controls for MM as well as 19 110 controls for MGUS, from 1988 to 2013, were included in the study. Longevity was defined as >90 years of age. Among MM patients, parental longevity was associated with a decreased risk of death [hazard ratio (HR) = 0·92, 95% confidence interval (CI) 0·84-0·99] and the same was true for MGUS patients (HR = 0·87, 95% CI 0·78-0·96). Having one long lived parent significantly decreased the risk of death in both groups, but was not statistically significant when both parents exceeded 90 years of age. In conclusion, parental longevity decreases the risk of death for patients with MM and MGUS which may reflect the importance of the host's genetic and environmental factors in relation to survival.
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Affiliation(s)
| | - Sigrún H Lund
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | | | - Magnus Björkholm
- Department of Medicine, Division of Haematology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Lynn R Goldin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ola Landgren
- Myeloma Service, Division of Hematology Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Sigurður Y Kristinsson
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland.,Department of Haematology, Landspitali, National University Hospital, Reykjavik, Iceland
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21
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Risk of MGUS in relatives of multiple myeloma cases by clinical and tumor characteristics. Leukemia 2018; 33:499-507. [PMID: 30201985 DOI: 10.1038/s41375-018-0246-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/13/2018] [Accepted: 08/01/2018] [Indexed: 12/14/2022]
Abstract
We and others have shown increased risk of monoclonal gammopathy of undetermined significance (MGUS) in first-degree relatives of patients with multiple myeloma (MM). Whether familial risk of MGUS differs by the MM proband's age at onset, tumor or clinical characteristics is unknown. MM and smoldering MM (SMM) cases (N = 430) were recruited from the Mayo Clinic in Rochester, Minnesota between 2005-2015. First-degree relatives over age 40 provided serum samples for evaluation of MGUS (N = 1179). Age and sex specific rates of MGUS among first-degree relatives were compared to a population-based sample. Cytogenetic subtypes were classified by Fluorescence in situ hybridization. MGUS was detected in 75 first-degree relatives for an age- and sex- adjusted prevalence of 5.8% (95% CI: 4.5-7.2). Prevalence of MGUS in first-degree relatives was 2.4 fold (95% CI: 1.9-2.9) greater than expected rates. Familial risk did not differ by proband's age at diagnosis, gender, isotype, IgH translocation, or trisomy. This study confirms first-degree relatives of MM cases have a significantly higher risk of MGUS compared to the general population, regardless of age, gender, or tumor characteristics. In selected situations, such as multiple affected first-degree relatives, screening of first-degree relatives of MM cases could be considered for follow-up and prevention strategies.
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22
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Multiple myeloma: family history and mortality in second primary cancers. Blood Cancer J 2018; 8:75. [PMID: 30087319 PMCID: PMC6081451 DOI: 10.1038/s41408-018-0108-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/14/2018] [Accepted: 05/21/2018] [Indexed: 11/09/2022] Open
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23
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Ali M, Ajore R, Wihlborg AK, Niroula A, Swaminathan B, Johnsson E, Stephens OW, Morgan G, Meissner T, Turesson I, Goldschmidt H, Mellqvist UH, Gullberg U, Hansson M, Hemminki K, Nahi H, Waage A, Weinhold N, Nilsson B. The multiple myeloma risk allele at 5q15 lowers ELL2 expression and increases ribosomal gene expression. Nat Commun 2018; 9:1649. [PMID: 29695719 PMCID: PMC5917026 DOI: 10.1038/s41467-018-04082-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 03/26/2018] [Indexed: 02/06/2023] Open
Abstract
Recently, we identified ELL2 as a susceptibility gene for multiple myeloma (MM). To understand its mechanism of action, we performed expression quantitative trait locus analysis in CD138+ plasma cells from 1630 MM patients from four populations. We show that the MM risk allele lowers ELL2 expression in these cells (Pcombined = 2.5 × 10−27; βcombined = −0.24 SD), but not in peripheral blood or other tissues. Consistent with this, several variants representing the MM risk allele map to regulatory genomic regions, and three yield reduced transcriptional activity in plasmocytoma cell lines. One of these (rs3777189-C) co-locates with the best-supported lead variants for ELL2 expression and MM risk, and reduces binding of MAFF/G/K family transcription factors. Moreover, further analysis reveals that the MM risk allele associates with upregulation of gene sets related to ribosome biogenesis, and knockout/knockdown and rescue experiments in plasmocytoma cell lines support a cause–effect relationship. Our results provide mechanistic insight into MM predisposition. ELL2 was recently discovered as a susceptibility gene for multiple myeloma (MM). Here, they show that the MM risk allele lowers ELL2 expression in plasma cells, that it also upregulates gene sets related to ribosome biogenesis, and that one of the linked variants reduces binding of MAFF/G/K family transcription factors.
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Affiliation(s)
- Mina Ali
- Department of Laboratory Medicine, Hematology and Transfusion Medicine, SE 221 84, Lund, Sweden
| | - Ram Ajore
- Department of Laboratory Medicine, Hematology and Transfusion Medicine, SE 221 84, Lund, Sweden
| | - Anna-Karin Wihlborg
- Department of Laboratory Medicine, Hematology and Transfusion Medicine, SE 221 84, Lund, Sweden
| | - Abhishek Niroula
- Department of Laboratory Medicine, Hematology and Transfusion Medicine, SE 221 84, Lund, Sweden
| | - Bhairavi Swaminathan
- Department of Laboratory Medicine, Hematology and Transfusion Medicine, SE 221 84, Lund, Sweden
| | - Ellinor Johnsson
- Department of Laboratory Medicine, Hematology and Transfusion Medicine, SE 221 84, Lund, Sweden
| | - Owen W Stephens
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Gareth Morgan
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Tobias Meissner
- Department of Molecular and Experimental Medicine, Avera Cancer Institute, Sioux Falls, SD, 57105, USA
| | - Ingemar Turesson
- Department of Laboratory Medicine, Hematology and Transfusion Medicine, SE 221 84, Lund, Sweden
| | - Hartmut Goldschmidt
- Department of Internal Medicine V, University of Heidelberg, 69117, Heidelberg, Germany.,National Center for Tumor Diseases, Ulm, 69120, Heidelberg, Germany
| | | | - Urban Gullberg
- Department of Laboratory Medicine, Hematology and Transfusion Medicine, SE 221 84, Lund, Sweden
| | - Markus Hansson
- Department of Laboratory Medicine, Hematology and Transfusion Medicine, SE 221 84, Lund, Sweden.,Hematology Clinic, Skåne University Hospital, SE 221 85, Lund, Sweden
| | - Kari Hemminki
- German Cancer Research Center, 69120, Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, SE 205 02, Malmö, Sweden
| | - Hareth Nahi
- Center for Hematology and Regenerative Medicine, Karolinska Institutet, SE 171 77, Stockholm, Sweden
| | - Anders Waage
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Niels Weinhold
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Björn Nilsson
- Department of Laboratory Medicine, Hematology and Transfusion Medicine, SE 221 84, Lund, Sweden. .,Broad Institute, 7 Cambridge Center, Cambridge, MA, 02142, USA.
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24
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El Arfani C, De Veirman K, Maes K, De Bruyne E, Menu E. Metabolic Features of Multiple Myeloma. Int J Mol Sci 2018; 19:E1200. [PMID: 29662010 PMCID: PMC5979361 DOI: 10.3390/ijms19041200] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 04/07/2018] [Accepted: 04/10/2018] [Indexed: 01/19/2023] Open
Abstract
Cancer is known for its cellular changes contributing to tumour growth and cell proliferation. As part of these changes, metabolic rearrangements are identified in several cancers, including multiple myeloma (MM), which is a condition whereby malignant plasma cells accumulate in the bone marrow (BM). These metabolic changes consist of generation, inhibition and accumulation of metabolites and metabolic shifts in MM cells. Changes in the BM micro-environment could be the reason for such adjustments. Enhancement of glycolysis and glutaminolysis is found in MM cells compared to healthy cells. Metabolites and enzymes can be upregulated or downregulated and play a crucial role in drug resistance. Therefore, this review will focus on changes in glucose and glutamine metabolism linked with the emergence of drug resistance. Moreover, metabolites do not only affect other metabolic components to benefit cancer development; they also interfere with transcription factors involved in proliferation and apoptotic regulation.
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Affiliation(s)
- Chaima El Arfani
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium.
| | - Kim De Veirman
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium.
| | - Ken Maes
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium.
| | - Elke De Bruyne
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium.
| | - Eline Menu
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium.
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25
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Bolli N, Barcella M, Salvi E, D'Avila F, Vendramin A, De Philippis C, Munshi NC, Avet-Loiseau H, Campbell PJ, Mussetti A, Carniti C, Maura F, Barlassina C, Corradini P, Montefusco V. Next-generation sequencing of a family with a high penetrance of monoclonal gammopathies for the identification of candidate risk alleles. Cancer 2017; 123:3701-3708. [DOI: 10.1002/cncr.30777] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/04/2017] [Accepted: 04/18/2017] [Indexed: 12/30/2022]
Affiliation(s)
- Niccolo Bolli
- Department of Oncology and Hemato-Oncology; University of Milan; Milan Italy
- Department of Hematology and Pediatric Onco-Hematology; IRCCS Foundation National Cancer Institute; Milan Italy
- The Cancer Genome Project; Wellcome Trust Sanger Institute; Cambridge United Kingdom
| | - Matteo Barcella
- Genomic and Bioinformatics Unit; Department of Health Sciences, University of Milan; Milan Italy
| | - Erika Salvi
- Genomic and Bioinformatics Unit; Department of Health Sciences, University of Milan; Milan Italy
| | - Francesca D'Avila
- Genomic and Bioinformatics Unit; Department of Health Sciences, University of Milan; Milan Italy
| | - Antonio Vendramin
- Department of Oncology and Hemato-Oncology; University of Milan; Milan Italy
- Department of Hematology and Pediatric Onco-Hematology; IRCCS Foundation National Cancer Institute; Milan Italy
| | - Chiara De Philippis
- Department of Oncology and Hemato-Oncology; University of Milan; Milan Italy
- Department of Hematology and Pediatric Onco-Hematology; IRCCS Foundation National Cancer Institute; Milan Italy
| | - Nikhil C. Munshi
- LeBow Institute for Myeloma Therapeutics; Jerome Lipper Center for Multiple Myeloma Research, Dana-Farber Cancer Institute, Harvard Medical School; Boston Massachusetts
| | - Herve Avet-Loiseau
- Laboratory for Genomics in Myeloma; University Cancer Center of Toulouse; CRCT INSERM 1037, Toulouse France
| | - Peter J. Campbell
- The Cancer Genome Project; Wellcome Trust Sanger Institute; Cambridge United Kingdom
| | - Alberto Mussetti
- Department of Hematology and Pediatric Onco-Hematology; IRCCS Foundation National Cancer Institute; Milan Italy
| | - Cristiana Carniti
- Department of Hematology and Pediatric Onco-Hematology; IRCCS Foundation National Cancer Institute; Milan Italy
| | - Francesco Maura
- Department of Oncology and Hemato-Oncology; University of Milan; Milan Italy
| | - Cristina Barlassina
- Genomic and Bioinformatics Unit; Department of Health Sciences, University of Milan; Milan Italy
| | - Paolo Corradini
- Department of Oncology and Hemato-Oncology; University of Milan; Milan Italy
- Department of Hematology and Pediatric Onco-Hematology; IRCCS Foundation National Cancer Institute; Milan Italy
| | - Vittorio Montefusco
- Department of Hematology and Pediatric Onco-Hematology; IRCCS Foundation National Cancer Institute; Milan Italy
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26
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Lindqvist EK, Landgren O, Lund SH, Turesson I, Hultcrantz M, Goldin L, Björkholm M, Kristinsson SY. History of autoimmune disease is associated with impaired survival in multiple myeloma and monoclonal gammopathy of undetermined significance: a population-based study. Ann Hematol 2017; 96:261-269. [PMID: 27807648 PMCID: PMC5226986 DOI: 10.1007/s00277-016-2859-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/11/2016] [Indexed: 12/25/2022]
Abstract
Multiple myeloma (MM) is a plasma cell disorder preceded by monoclonal gammopathy of undetermined significance (MGUS). Incidence of MM and MGUS is higher among patients with autoimmune disease. The aim of this study was to determine whether a history of autoimmunity has an impact on survival in MM and MGUS. Using high-quality national Swedish registries, we identified 8367 patients with MM, 18,768 patients with MGUS, and 110,251 matched control subjects, and obtained information on previous autoimmune disease in patients and controls. Cox regression was used to calculate hazard ratios (HRs) for overall survival with 95 % confidence intervals (CIs). In patients with MM and a prior autoimmune disease, the risk of death was significantly increased, HR = 1.2 (95 % CI 1.2-1.3) compared to MM patients with no history of autoimmunity. In MGUS patients, a prior autoimmune disease was associated with a significantly 1.4-fold elevated risk of death (95 % CI 1.3-1.4). When analyzing different types of autoimmune diseases, a history of ulcerative colitis had a stronger impact on survival in MM than in controls. Our findings that a history of autoimmune disease has a negative impact on survival in MM and MGUS could be due to shared underlying common genetic factors, or that patients with a history of autoimmunity develop more severe cases of MM and MGUS, or cumulative comorbidity in the individual. Our results suggest that more attention should be paid to comorbidity as a prognostic factor in MGUS and MM, and underlines the need for studies aimed at tailoring therapy according to comorbidity.
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Affiliation(s)
- Ebba K Lindqvist
- Department of Medicine, Division of Hematology, Karolinska University Hospital and Karolinska Institutet, 171 76, Stockholm, Sweden.
| | - Ola Landgren
- Department of Medicine, Myeloma Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Sigrún H Lund
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ingemar Turesson
- Department of Hematology and Coagulation Disorders, Skåne University Hospital, Malmö, Sweden
| | - Malin Hultcrantz
- Department of Medicine, Division of Hematology, Karolinska University Hospital and Karolinska Institutet, 171 76, Stockholm, Sweden
- Department of Medicine, Myeloma Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Lynn Goldin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Magnus Björkholm
- Department of Medicine, Division of Hematology, Karolinska University Hospital and Karolinska Institutet, 171 76, Stockholm, Sweden
| | - Sigurdur Y Kristinsson
- Department of Medicine, Division of Hematology, Karolinska University Hospital and Karolinska Institutet, 171 76, Stockholm, Sweden
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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27
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Law PJ, Sud A, Mitchell JS, Henrion M, Orlando G, Lenive O, Broderick P, Speedy HE, Johnson DC, Kaiser M, Weinhold N, Cooke R, Sunter NJ, Jackson GH, Summerfield G, Harris RJ, Pettitt AR, Allsup DJ, Carmichael J, Bailey JR, Pratt G, Rahman T, Pepper C, Fegan C, von Strandmann EP, Engert A, Försti A, Chen B, Filho MIDS, Thomsen H, Hoffmann P, Noethen MM, Eisele L, Jöckel KH, Allan JM, Swerdlow AJ, Goldschmidt H, Catovsky D, Morgan GJ, Hemminki K, Houlston RS. Genome-wide association analysis of chronic lymphocytic leukaemia, Hodgkin lymphoma and multiple myeloma identifies pleiotropic risk loci. Sci Rep 2017; 7:41071. [PMID: 28112199 PMCID: PMC5253627 DOI: 10.1038/srep41071] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 12/14/2016] [Indexed: 02/08/2023] Open
Abstract
B-cell malignancies (BCM) originate from the same cell of origin, but at different maturation stages and have distinct clinical phenotypes. Although genetic risk variants for individual BCMs have been identified, an agnostic, genome-wide search for shared genetic susceptibility has not been performed. We explored genome-wide association studies of chronic lymphocytic leukaemia (CLL, N = 1,842), Hodgkin lymphoma (HL, N = 1,465) and multiple myeloma (MM, N = 3,790). We identified a novel pleiotropic risk locus at 3q22.2 (NCK1, rs11715604, P = 1.60 × 10-9) with opposing effects between CLL (P = 1.97 × 10-8) and HL (P = 3.31 × 10-3). Eight established non-HLA risk loci showed pleiotropic associations. Within the HLA region, Ser37 + Phe37 in HLA-DRB1 (P = 1.84 × 10-12) was associated with increased CLL and HL risk (P = 4.68 × 10-12), and reduced MM risk (P = 1.12 × 10-2), and Gly70 in HLA-DQB1 (P = 3.15 × 10-10) showed opposing effects between CLL (P = 3.52 × 10-3) and HL (P = 3.41 × 10-9). By integrating eQTL, Hi-C and ChIP-seq data, we show that the pleiotropic risk loci are enriched for B-cell regulatory elements, as well as an over-representation of binding of key B-cell transcription factors. These data identify shared biological pathways influencing the development of CLL, HL and MM. The identification of these risk loci furthers our understanding of the aetiological basis of BCMs.
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Affiliation(s)
- Philip J. Law
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Amit Sud
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Jonathan S. Mitchell
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Marc Henrion
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Giulia Orlando
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Oleg Lenive
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Peter Broderick
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Helen E. Speedy
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - David C. Johnson
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Martin Kaiser
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Niels Weinhold
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Rosie Cooke
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Nicola J. Sunter
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Graham H. Jackson
- Department of Haematology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Geoffrey Summerfield
- Department of Haematology, Queen Elizabeth Hospital, Gateshead, Newcastle upon Tyne, UK
| | - Robert J. Harris
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Andrew R. Pettitt
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - David J. Allsup
- Queens Centre for Haematology and Oncology, Castle Hill Hospital, Hull and East Yorkshire NHS Trust, UK
| | - Jonathan Carmichael
- Queens Centre for Haematology and Oncology, Castle Hill Hospital, Hull and East Yorkshire NHS Trust, UK
| | - James R. Bailey
- Queens Centre for Haematology and Oncology, Castle Hill Hospital, Hull and East Yorkshire NHS Trust, UK
| | - Guy Pratt
- Department of Haematology, Birmingham Heartlands Hospital, Birmingham, UK
| | - Thahira Rahman
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Chris Pepper
- Department of Haematology, School of Medicine, Cardiff University, Cardiff, UK
| | - Chris Fegan
- Cardiff and Vale National Health Service Trust, Heath Park, Cardiff, UK
| | | | - Andreas Engert
- Department of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Centre, Heidelberg, Germany
- Centre for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Bowang Chen
- Division of Molecular Genetic Epidemiology, German Cancer Research Centre, Heidelberg, Germany
| | | | - Hauke Thomsen
- Division of Molecular Genetic Epidemiology, German Cancer Research Centre, Heidelberg, Germany
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, Germany
- Division of Medical Genetics, Department of Biomedicine, University of Basel, Switzerland
| | - Markus M. Noethen
- Institute of Human Genetics, University of Bonn, Germany
- Department of Genomics, Life & Brain Center, University of Bonn, Germany
| | | | | | - James M. Allan
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Anthony J. Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Hartmut Goldschmidt
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
- National Center of Tumor Diseases, Heidelberg, Germany
| | - Daniel Catovsky
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Gareth J. Morgan
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Centre, Heidelberg, Germany
- Centre for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Richard S. Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
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28
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Macauda A, Calvetti D, Maccari G, Hemminki K, Försti A, Goldschmidt H, Weinhold N, Houlston R, Andersen V, Vogel U, Buda G, Varkonyi J, Sureda A, Martinez Lopez J, Watek M, Butrym A, Sarasquete ME, Dudziński M, Jurczyszyn A, Druzd-Sitek A, Kruszewski M, Subocz E, Petrini M, Iskierka-Jażdżewska E, Raźny M, Szombath G, Marques H, Zawirska D, Chraniuk D, Halka J, Hove Jacobsen SE, Mazur G, García Sanz R, Dumontet C, Moreno V, Stępień A, Beider K, Pelosini M, Manuel Reis R, Krawczyk-Kulis M, Rymko M, Avet-Loiseau H, Lesueur F, Grząśko N, Ostrovsky O, Jamroziak K, Vangsted AJ, Jerez A, Tomczak W, Zaucha JM, Kadar K, Sainz J, Nagler A, Landi S, Gemignani F, Canzian F. Identification of miRSNPs associated with the risk of multiple myeloma. Int J Cancer 2016; 140:526-534. [DOI: 10.1002/ijc.30465] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 08/24/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Angelica Macauda
- Department of Biology; University of Pisa; Pisa Italy
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Diego Calvetti
- Department of Biology; University of Pisa; Pisa Italy
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Giuseppe Maccari
- The Pirbright Institute, Pirbright; Woking Surrey GU24 0NF United Kingdom
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Asta Försti
- Division of Molecular Genetic Epidemiology; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Hartmut Goldschmidt
- Department of Internal Medicine V; University of Heidelberg; Heidelberg Germany
| | - Niels Weinhold
- Department of Internal Medicine V; University of Heidelberg; Heidelberg Germany
| | - Richard Houlston
- Division of Genetics and Epidemiology; The Institute of Cancer Research; London United Kingdom
| | - Vibeke Andersen
- Institute of Regional Health Research, and Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark; Odense Denmark
- Research Unit of Molecular Diagnostics and Clinical Research, Laboratory Center, Hospital of Southern Jutland; Aabenraa Denmark
| | - Ulla Vogel
- National Research Centre for the Working Environment; Copenhagen DK-2100 Denmark
| | - Gabriele Buda
- UO Hematology, Department of Internal and Experimental Medicine; University of Pisa; Pisa Italy
| | - Judit Varkonyi
- Department of Hematology; Semmelweis University; Budapest Hungary
| | - Anna Sureda
- Department of Hematology; Catalan Institute of Oncology (ICO) and IDIBELL; Barcelona Spain
| | - Joaquin Martinez Lopez
- Department of Hematology; Hospital Universitario 12 de Octubre, Complutense School of Medicine, CNIO; Madrid Spain
| | | | | | | | - Marek Dudziński
- Department of Hematology; Specialist District Hospital; Rzeszow Poland
| | - Artur Jurczyszyn
- Department of Hematology; Cracow University Hospital; Cracow Poland
| | - Agnieszka Druzd-Sitek
- Department of Lymphoid Malignancies Maria Sklodowska-Curie Memorial Institute and Oncology Centre Warsaw; Warsaw Poland
| | | | - Edyta Subocz
- Department of Hematology; Military Institute of Medicine; Warsaw Poland
| | - Mario Petrini
- UO Hematology, Department of Internal and Experimental Medicine; University of Pisa; Pisa Italy
| | | | | | - Gergely Szombath
- Department of Hematology; Semmelweis University; Budapest Hungary
| | - Herlander Marques
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho; Braga Portugal
- ICVS/3B's-PT Government Associate Laboratory; Braga Portugal
| | - Daria Zawirska
- Department of Hematology; Cracow University Hospital; Cracow Poland
| | | | - Janusz Halka
- Department of Hematology; Military Institute of Medicine; Warsaw Poland
| | | | - Grzegorz Mazur
- Department of Internal Diseases, Hypertension and Occupational Medicine; Medical University; Wroclaw Poland
| | - Ramón García Sanz
- Department of Hematology; University Hospital of Salamanca; Salamanca Spain
| | - Charles Dumontet
- INSERM UMR 1052/CNRS 5286, Université Claude Bernard Lyon I; Lyon 69622 France
| | - Victor Moreno
- Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO), IDIBELL, CIBERESP and Department of Clinical Sciences, Faculty of Medicine; University of Barcelona; Barcelona Spain
| | - Anna Stępień
- Laboratory of Clinical and Transplant Immunology and Genetics; Copernicus Memorial Hospital; Łódź Poland
| | - Katia Beider
- Chaim Sheba Medical Center; Tel-Hashomer Ramat Gan Israel
| | - Matteo Pelosini
- Azienda USL Toscana Nord Ovest; U.O Dipartimento di Ematologia; Livorno, Italy
| | - Rui Manuel Reis
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho; Braga Portugal
- ICVS/3B's-PT Government Associate Laboratory; Braga Portugal
- Barretos Cancer Hospital; Molecular Oncology Research Center; Barretos Brazil
| | - Malgorzata Krawczyk-Kulis
- Department of Hematology and Bone marrow Transplantation; Silesian Medical University; Katowice Poland
| | - Marcin Rymko
- Department of Hematology; Copernicus Hospital; Torun Poland
| | - Hervé Avet-Loiseau
- Laboratoire d'hématologie, Pôle biologie; Institut Universitaire du Cancer de Toulouse-Oncopole 1; Avenue Irène Joliot-Curie, Toulouse 31059 France
| | - Fabienne Lesueur
- Institut Curie; 26 rue d'Ulm Paris F-75005 France
- PSL Research University; Paris F-75005 France
- Inserm, U900; Paris F-75005 France
- Mines Paris Tech; Fontainebleau, Paris F-77305 France
| | - Norbert Grząśko
- Department of Hematology; St. John's Cancer Center; Lublin Poland
| | - Olga Ostrovsky
- Chaim Sheba Medical Center; Tel-Hashomer Ramat Gan Israel
| | - Krzysztof Jamroziak
- Department of Hematology; Institute of Hematology and Transfusion Medicine; Warsaw Poland
| | - Annette J. Vangsted
- Department of Haematology, Rigshospitalet; Copenhagen University; Copenhagen Denmark
| | - Andrés Jerez
- Department of Hematology and Medical Oncology; IMIB, University Hospital Morales Meseguer; Murcia Spain
| | - Waldemar Tomczak
- Department of Hematooncology and Bone Marrow Transplantation; Medical University of Lublin; Lublin Poland
| | | | - Katalin Kadar
- Department of Hematology; Semmelweis University; Budapest Hungary
| | - Juan Sainz
- Centro Pfizer, Universidad de Granada, Junta de Andalucía de Genómica e Investigación Oncológica (GENYO); Granada Spain
| | - Arnon Nagler
- Chaim Sheba Medical Center; Tel-Hashomer Ramat Gan Israel
| | - Stefano Landi
- Department of Biology; University of Pisa; Pisa Italy
| | | | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ); Heidelberg Germany
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29
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Feurstein S, Drazer MW, Godley LA. Genetic predisposition to leukemia and other hematologic malignancies. Semin Oncol 2016; 43:598-608. [DOI: 10.1053/j.seminoncol.2016.10.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 10/12/2016] [Indexed: 01/08/2023]
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30
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Schinasi LH, Brown EE, Camp NJ, Wang SS, Hofmann JN, Chiu BC, Miligi L, Beane Freeman LE, de Sanjose S, Bernstein L, Monnereau A, Clavel J, Tricot GJ, Atanackovic D, Cocco P, Orsi L, Dosman JA, McLaughlin JR, Purdue MP, Cozen W, Spinelli JJ, de Roos AJ. Multiple myeloma and family history of lymphohaematopoietic cancers: Results from the International Multiple Myeloma Consortium. Br J Haematol 2016; 175:87-101. [PMID: 27330041 DOI: 10.1111/bjh.14199] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 04/06/2016] [Indexed: 01/31/2023]
Abstract
Family clusters of multiple myeloma (MM) suggest disease heritability. Nevertheless, patterns of inheritance and the importance of genetic versus environmental risk factors in MM aetiology remain unclear. We pooled data from eleven case-control studies from the International Multiple Myeloma Consortium to characterize the association of MM risk with having a first-degree relative with a history of a lympho-haematapoietic cancer. Unconditional logistic regression models, adjusted for study, sex, age and education level, were used to estimate associations between MM risk and having a first-degree relative with a history of non-Hodgkin lymphoma, Hodgkin lymphoma, leukaemia or MM. Sex, African American race/ethnicity and age were explored as effect modifiers. A total of 2843 cases and 11 470 controls were included. MM risk was elevated in association with having a first-degree relative with any lympho-haematapoietic cancer (Odds Ratio (OR) = 1·29, 95% Confidence Interval (CI): 1·08-1·55). The association was particularly strong for having a first-degree relative with MM (OR = 1·90, 95% CI: 1·26-2·87), especially among men (OR = 4·13, 95% CI: 2·17-7·85) and African Americans (OR = 5·52, 95% CI: 1·87-16·27).These results support the hypothesis that genetic inheritance plays a role in MM aetiology. Future studies are warranted to characterize interactions of genetic markers with environmental exposures.
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Affiliation(s)
- Leah H Schinasi
- Department of Environmental and Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.
| | - Elizabeth E Brown
- Department of Pathology and Comprehensive Cancer Center, School of Medicine, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Nicola J Camp
- Division of Hematology and Hematologic Malignancies, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Sophia S Wang
- Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Jonathan N Hofmann
- Occupational and Environmental Epidemiology Branch, Division of Cancer and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Brian C Chiu
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Lucia Miligi
- Institute for Study and Prevention of Cancer, Unit of Environmental and Occupational Health, Florence, Italy
| | - Laura E Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Silvia de Sanjose
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain
| | - Leslie Bernstein
- Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Alain Monnereau
- INSERM U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Paris-Descartes University, UMRS-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Paris, France
| | - Jacqueline Clavel
- INSERM U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Paris-Descartes University, UMRS-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Paris, France
| | - Guido J Tricot
- Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - Djordje Atanackovic
- Division of Hematology and Hematologic Malignancies, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Pierluigi Cocco
- Department of Public Health, Clinical and Molecular Medicine, Occupational Health Section, University of Cagliari, Cagliari, Italy
| | - Laurent Orsi
- INSERM U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Paris-Descartes University, UMRS-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Paris, France
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, USA
| | | | - Mark P Purdue
- Occupational and Environmental Epidemiology Branch, Division of Cancer and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Wendy Cozen
- Departments of Preventive Medicine and Pathology, USC Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - John J Spinelli
- Cancer Control Research, BC Cancer Agency, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Anneclaire J de Roos
- Department of Environmental and Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
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VanValkenburg ME, Pruitt GI, Brill IK, Costa L, Ehtsham M, Justement IT, Innis-Shelton RD, Salzman D, Reddy ESP, Godby KN, Mikhail FM, Carroll AJ, Reddy VB, Sanderson RD, Justement LB, Sanders PW, Brown EE. Family history of hematologic malignancies and risk of multiple myeloma: differences by race and clinical features. Cancer Causes Control 2016; 27:81-91. [PMID: 26596855 PMCID: PMC4703620 DOI: 10.1007/s10552-015-0685-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 10/16/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE Multiple myeloma (MM) is the most common hematologic malignancy affecting Blacks in the USA, with standardized incidence rates that are twofold to threefold higher than Whites. The rationale for the disparity is unclear. METHODS Using participants enrolled in the Molecular And Genetic Epidemiology study of myeloma (259 MM cases; 461 controls), we examined the risk of MM associated with family history of cancer, differences by race and among cases, defining clinical features. Risk estimates were calculated using odds ratios and corresponding 95% confidence intervals from logistic regression adjusted for confounders. RESULTS Overall, MM risk in cases with relatives affected with any hematologic malignancy was significantly elevated compared to controls (OR 1.89, 95% CI 1.25-2.86). Myeloma risk associated with a family history of MM was higher than the risk associated with any hematologic malignancy (OR 3.75, 95% CI 1.75-8.05), and the effect was greater for Blacks (OR 20.9, 95% CI 2.59-168) than Whites (OR 2.04, 95% 0.83-5.04), among cases with early onset (≤60 years; OR 4.58, 95% CI 1.21-17.3) and with increasing numbers of affected relatives (p trend = 0.001). Overall, frequencies of end organ damage differed in cases with relatives affected with any hematologic malignancy and significantly more cases exhibited κ light chain restriction (OR 3.23, 95% CI 1.13-9.26). CONCLUSIONS The excess risk of MM observed in Blacks and the variation in clinical features observed in MM patients according to family history of hematologic malignancy may be attributed to a shared germline and environmental susceptibility.
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Affiliation(s)
- MaryAnn E VanValkenburg
- Department of Pathology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294-3300, USA
| | - Gwendolyn I Pruitt
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ilene K Brill
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Luciano Costa
- Division of Hematology and Medical Oncology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Maryam Ehtsham
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ian T Justement
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Racquel D Innis-Shelton
- Division of Hematology and Medical Oncology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Donna Salzman
- Division of Hematology and Medical Oncology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - E Shyam P Reddy
- Cancer Biology Program, Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, GA, USA
| | - Kelly N Godby
- Division of Hematology and Medical Oncology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Fady M Mikhail
- Department of Genetics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andrew J Carroll
- Department of Genetics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Vishnu B Reddy
- Department of Pathology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294-3300, USA
- UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ralph D Sanderson
- Department of Pathology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294-3300, USA
- UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Louis B Justement
- UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Microbiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Paul W Sanders
- UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
- Division of Nephrology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Veterans Affairs Medical Center, Birmingham, AL, USA
| | - Elizabeth E Brown
- Department of Pathology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294-3300, USA.
- UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
- , 1824 6th Avenue South, WTI 602C, Birmingham, AL, 35294-3300, USA.
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32
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Search for familial clustering of multiple myeloma with any cancer. Leukemia 2015; 30:627-32. [PMID: 26449663 DOI: 10.1038/leu.2015.279] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 09/30/2015] [Accepted: 10/02/2015] [Indexed: 01/08/2023]
Abstract
Multiple myeloma (MM) is a disease of immunoglobulin-producing plasma cells, which reside mainly in the bone marrow. Family members of MM patients are at a risk of MM, but whether other malignancies are in excess in family members is not established and is the aim of this study. MM patients (24 137) were identified from the Swedish Cancer Registry from years 1958 to 2012. Relative risks (RRs) were calculated for MM defined by any cancer diagnosed in first-degree relatives and compared with individuals whose relatives had no cancer. MM was reliably associated with relative's colorectal, breast and prostate cancers, non-thyroid endocrine tumors, leukemia and cancer of unknown primary; in addition, MM was associated with subsites of bone and connective tissue tumors and of non-Hodgkin lymphoma, including lymphoplasmacytic lymphoma/Waldenström macroglobulinema (RR 3.47). MM showed a strong association (RR 1.91) in colorectal cancer families, possibly as part of an unidentified syndrome. All the associations of MM with discordant cancers are novel suggesting that MM shares genetic susceptibility with many cancers. The associations of MM bone and connective tissue tumors were supported by at least two independent results. Whether the results signal bone-related biology shared by MM and these tumors deserves further study.
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33
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Swaminathan B, Thorleifsson G, Jöud M, Ali M, Johnsson E, Ajore R, Sulem P, Halvarsson BM, Eyjolfsson G, Haraldsdottir V, Hultman C, Ingelsson E, Kristinsson SY, Kähler AK, Lenhoff S, Masson G, Mellqvist UH, Månsson R, Nelander S, Olafsson I, Sigurðardottir O, Steingrimsdóttir H, Vangsted A, Vogel U, Waage A, Nahi H, Gudbjartsson DF, Rafnar T, Turesson I, Gullberg U, Stefánsson K, Hansson M, Thorsteinsdóttir U, Nilsson B. Variants in ELL2 influencing immunoglobulin levels associate with multiple myeloma. Nat Commun 2015; 6:7213. [PMID: 26007630 PMCID: PMC4455110 DOI: 10.1038/ncomms8213] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/20/2015] [Indexed: 02/07/2023] Open
Abstract
Multiple myeloma (MM) is characterized by an uninhibited, clonal growth of plasma cells. While first-degree relatives of patients with MM show an increased risk of MM, the genetic basis of inherited MM susceptibility is incompletely understood. Here we report a genome-wide association study in the Nordic region identifying a novel MM risk locus at ELL2 (rs56219066T; odds ratio (OR)=1.25; P=9.6 × 10(-10)). This gene encodes a stoichiometrically limiting component of the super-elongation complex that drives secretory-specific immunoglobulin mRNA production and transcriptional regulation in plasma cells. We find that the MM risk allele harbours a Thr298Ala missense variant in an ELL2 domain required for transcription elongation. Consistent with a hypomorphic effect, we find that the MM risk allele also associates with reduced levels of immunoglobulin A (IgA) and G (IgG) in healthy subjects (P=8.6 × 10(-9) and P=6.4 × 10(-3), respectively) and, potentially, with an increased risk of bacterial meningitis (OR=1.30; P=0.0024).
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Affiliation(s)
- Bhairavi Swaminathan
- Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, BMC B13, SE-221 84 Lund, Sweden
| | | | - Magnus Jöud
- 1] Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, BMC B13, SE-221 84 Lund, Sweden [2] Clinical Immunology and Transfusion Medicine, Laboratory Medicine, Office of Medical Services, Akutgatan 8, SE-221 85 Lund, Sweden
| | - Mina Ali
- Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, BMC B13, SE-221 84 Lund, Sweden
| | - Ellinor Johnsson
- Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, BMC B13, SE-221 84 Lund, Sweden
| | - Ram Ajore
- Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, BMC B13, SE-221 84 Lund, Sweden
| | - Patrick Sulem
- deCODE genetics, Sturlugata 8, IS-101 Reykjavik, Iceland
| | - Britt-Marie Halvarsson
- Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, BMC B13, SE-221 84 Lund, Sweden
| | | | - Vilhelmina Haraldsdottir
- Department of Hematology, Landspitali, The National University Hospital of Iceland, IS-101 Reykjavik, Iceland
| | - Christina Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Erik Ingelsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, SE-751 85 Uppsala, Sweden
| | | | - Anna K Kähler
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Stig Lenhoff
- Hematology Clinic, Skåne University Hospital, SE-221 85 Lund, Sweden
| | - Gisli Masson
- deCODE genetics, Sturlugata 8, IS-101 Reykjavik, Iceland
| | - Ulf-Henrik Mellqvist
- Section of Hematology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - Robert Månsson
- Center for Hematology and Regenerative Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Sven Nelander
- Department of Immunology, Pathology and Genetics, Uppsala University, Rudbeck Laboratory, SE-751 05 Uppsala, Sweden
| | - Isleifur Olafsson
- Department of Clinical Biochemistry, Landspitali, The National University Hospital of Iceland, IS-101 Reykjavik, Iceland
| | - Olof Sigurðardottir
- Department of Clinical Biochemistry, Akureyri Hospital, IS-600 Akureyri, Iceland
| | - Hlif Steingrimsdóttir
- Department of Hematology, Landspitali, The National University Hospital of Iceland, IS-101 Reykjavik, Iceland
| | - Annette Vangsted
- Department of Haematology, University Hospital of Copenhagen at Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Ulla Vogel
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark
| | - Anders Waage
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Box 8905, N-7491 Trondheim, Norway
| | - Hareth Nahi
- Center for Hematology and Regenerative Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | | | - Thorunn Rafnar
- deCODE genetics, Sturlugata 8, IS-101 Reykjavik, Iceland
| | - Ingemar Turesson
- Hematology Clinic, Skåne University Hospital, SE-221 85 Lund, Sweden
| | - Urban Gullberg
- Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, BMC B13, SE-221 84 Lund, Sweden
| | | | - Markus Hansson
- 1] Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, BMC B13, SE-221 84 Lund, Sweden [2] Hematology Clinic, Skåne University Hospital, SE-221 85 Lund, Sweden
| | | | - Björn Nilsson
- 1] Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, BMC B13, SE-221 84 Lund, Sweden [2] Clinical Immunology and Transfusion Medicine, Laboratory Medicine, Office of Medical Services, Akutgatan 8, SE-221 85 Lund, Sweden [3] Broad Institute, 7 Cambridge Center, Cambridge, Massachusetts 02142, USA
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Boyle EM, Davies FE, Leleu X, Morgan GJ. Understanding the multiple biological aspects leading to myeloma. Haematologica 2015; 99:605-12. [PMID: 24688108 DOI: 10.3324/haematol.2013.097907] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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35
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van de Donk NWCJ, Palumbo A, Johnsen HE, Engelhardt M, Gay F, Gregersen H, Hajek R, Kleber M, Ludwig H, Morgan G, Musto P, Plesner T, Sezer O, Terpos E, Waage A, Zweegman S, Einsele H, Sonneveld P, Lokhorst HM. The clinical relevance and management of monoclonal gammopathy of undetermined significance and related disorders: recommendations from the European Myeloma Network. Haematologica 2014; 99:984-96. [PMID: 24658815 PMCID: PMC4040895 DOI: 10.3324/haematol.2013.100552] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 03/14/2014] [Indexed: 12/18/2022] Open
Abstract
Monoclonal gammopathy of undetermined significance is one of the most common pre-malignant disorders. IgG and IgA monoclonal gammopathy of undetermined significance are precursor conditions of multiple myeloma; light-chain monoclonal gammopathy of undetermined significance of light-chain multiple myeloma; and IgM monoclonal gammopathy of undetermined significance of Waldenström's macroglobulinemia and other lymphoproliferative disorders. Clonal burden, as determined by bone marrow plasma cell percentage or M-protein level, as well as biological characteristics, including heavy chain isotype and light chain production, are helpful in predicting risk of progression of monoclonal gammopathy of undetermined significance to symptomatic disease. Furthermore, alterations in the bone marrow microenvironment of monoclonal gammopathy of undetermined significance patients result in an increased risk of venous and arterial thrombosis, infections, osteoporosis, and bone fractures. In addition, the small clone may occasionally be responsible for severe organ damage through the production of a monoclonal protein that has autoantibody activity or deposits in tissues. These disorders are rare and often require therapy directed at eradication of the underlying plasma cell or lymphoplasmacytic clone. In this review, we provide an overview of the clinical relevance of monoclonal gammopathy of undetermined significance. We also give general recommendations of how to diagnose and manage patients with monoclonal gammopathy of undetermined significance.
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Affiliation(s)
| | - Antonio Palumbo
- Divisione di Ematologia dell'Università di Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Hans Erik Johnsen
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark
| | - Monika Engelhardt
- Department of Hematology and Oncology, University of Freiburg Medical Center, Germany
| | - Francesca Gay
- Divisione di Ematologia dell'Università di Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Henrik Gregersen
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark
| | - Roman Hajek
- Department of Haemato-oncology, University Hospital Ostrava and Faculty of Medicine, Czech Republic
| | - Martina Kleber
- Department of Hematology and Oncology, University of Freiburg Medical Center, Germany
| | - Heinz Ludwig
- Department of Medicine I, Wilhelminenspital Wien, Austria
| | - Gareth Morgan
- Institute of Cancer Research, Royal Marsden Hospital, London, UK
| | - Pellegrino Musto
- Scientific Direction, Centro di Riferimento Oncologico della Basilicata, Istituto di Ricovero e Cura a Carattere Scientifico, Rionero in Vulture, Italy
| | | | - Orhan Sezer
- Department of Hematology, Memorial Hospital, Istanbul, Turkey
| | - Evangelos Terpos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Greece
| | - Anders Waage
- Department of Hematology, St. Olavs Hospital, Norwegian University of Science and Technology, Trondheim, Norway
| | - Sonja Zweegman
- Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
| | - Hermann Einsele
- Universitätsklinik Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany
| | - Pieter Sonneveld
- Department of Hematology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Henk M Lokhorst
- Department of Hematology, University Medical Center Utrecht, The Netherlands
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Leiba M, Afek A, Derazne E, Keinan-Boker L, Leiba A, Nagler A, Shamiss A, Kark JD. Israeli-born offspring of Jewish immigrants of Middle Eastern origin have a lower incidence of multiple myeloma than those of European origin: a cohort study of 746 200 Israeli men followed from late adolescence. Leuk Lymphoma 2014; 55:2290-5. [PMID: 24359241 DOI: 10.3109/10428194.2013.871276] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Differences in the prevalence of multiple myeloma across races have been observed, with a two- to three-fold greater prevalence in African Americans compared with Caucasians. Little is known about the incidence or prevalence of multiple myeloma in other populations. The association between father's country of origin and the incidence of multiple myeloma was examined in a nationwide population-based cohort. Health-related data on 746 200 16-19-year-old Jewish males examined between 1967 and 1998 were linked to the Israel National Cancer Registry to derive multiple myeloma incidence up to 2006. During 17 352 349 person-years of follow-up, 109 examinees developed plasma cell dyscrasias. Middle Eastern origin was protective compared to European origin (hazard ratio [HR] 0.39; 95% confidence interval [CI] 0.22-0.68; p = 0.001, adjusted for year of birth), and also when restricted to Israeli-born males (HR 0.44; 95% CI 0.24-0.82; p = 0.01). In conclusion, second-generation adolescents of Middle Eastern origin are at persistently lower risk of developing multiple myeloma compared to those of European origin, supporting a genetic component in the pathogenesis of multiple myeloma.
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Affiliation(s)
- Merav Leiba
- Multiple Myeloma Clinic, Division of Hematology and Bone Marrow Transplantation, Sheba Medical Center , Tel-Hashomer , Israel
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Engelhardt M, Wäsch R, Landgren O, Kleber M. Multiple myeloma and second malignancies. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2013; 14:98-101. [PMID: 24445186 DOI: 10.1016/j.clml.2013.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 11/17/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Monika Engelhardt
- Department of Hematology and Oncology, University of Freiburg Medical Center, Freiburg, Germany
| | - Ralph Wäsch
- Department of Hematology and Oncology, University of Freiburg Medical Center, Freiburg, Germany
| | - Ola Landgren
- Multiple Myeloma Section, Metabolism Branch, National Cancer Institute, Bethesda, MD
| | - Martina Kleber
- Department of Hematology and Oncology, University of Freiburg Medical Center, Freiburg, Germany
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38
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Abstract
Multiple myeloma (MM) is the second most common hematologic malignancy in the United States, after non-Hodgkin lymphoma. Family pedigree analyses of high-risk families, case-control studies and racial disparities in disease incidence all point to a potential inherited predisposition to MM. Genome-wide association studies (GWASs) have identified susceptibility loci in a number of cancers and such studies are currently underway in MM. To date, GWASs in MM have identified several potential regions of interest for further study on chromosomes 3p22, 7p15.3, 8q24 and 2p23.3. In addition, several targets of paraproteins (so called 'paratargs') in MM have been identified. Hyperphosphorylation of the paratarg protein, which is inherited in an autosomal dominant manner, appears a common mechanism underlying the antigenicity of these proteins. One particular protein, hyperphosphorylated paratarg-7 (pP-7) is a common target in persons with myeloma and has also been identified in affected members of several high-risk MM families. It appears that the frequency of pP-7 as an antigenic target may be particularly high in African American patients with MM, which could be part of the explanation for observed racial disparities in the incidence of MM. In this review we focus on available data in the area of inherited predisposition to MM, and highlight future research directions.
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Affiliation(s)
- Divya T Koura
- The Winship Cancer Institute of Emory University, Atlanta, GA, USA
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39
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Goldin LR, McMaster ML, Caporaso NE. Precursors to lymphoproliferative malignancies. Cancer Epidemiol Biomarkers Prev 2013; 22:533-9. [PMID: 23549397 PMCID: PMC3616401 DOI: 10.1158/1055-9965.epi-12-1348] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
We review monoclonal B-cell lymphocytosis (MBL) as a precursor to chronic lymphocytic leukemia and monoclonal gammopathy of undetermined significance (MGUS) as a precursor to plasma cell disorders. These conditions are present in the general population and increase with age. These precursors aggregate with lymphoproliferative malignancies in families suggesting shared inheritance. MBL and MGUS may share some of the same risk factors as their related malignancies but data are limited. Although these conditions are characterized by enhanced risk for the associated malignancy, the majority of individuals with these conditions do not progress to malignancy. A key focus for current work is to identify markers that predict progression to malignancy.
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Affiliation(s)
- Lynn R Goldin
- Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, 6120 Executive Blvd., Bethesda, MD 20892, USA.
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40
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Dasanu CA, Mewawalla P, Grabska J. Multiple myeloma and its therapies: to what extent do they contribute to the increased incidence of second malignant neoplasms? Curr Med Res Opin 2012; 28:1129-40. [PMID: 22533678 DOI: 10.1185/03007995.2012.688800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The high risk of another cancer once one has been diagnosed is well known. Furthermore, a clear association exists between the use of some cytotoxic agents and chemotherapy-induced malignancies. METHODS This review is set to explore the relationship between multiple myeloma, its modern therapies and the development of second cancers due to various genetic, immune, and environmental (including iatrogenic) factors. Most relevant publications were identified through the PubMed database and by reviewing the drug information released by the US Federal Drug Administration. FINDINGS Our comprehensive analysis identified several retrospective population studies, cohort group analyses and a number of case reports linking myeloma with other cancers in the world literature. A majority of these studies suggest that incidence of second solid and hematologic malignancies is significantly increased in patients with multiple myeloma and its precursor lesion, monoclonal gammopathy of unknown significance. In addition, incidence of second malignancies has been found increased in the family members of these individuals, especially in their first-degree relatives. CONCLUSIONS Analysis of the existing literature cohorts does not discriminate between the burden of second cancers in treated myeloma patients as opposed to the patients followed with the wait-and-watch approach. Notably, the rate of second malignant neoplasms in multiple myeloma may be further increased by certain myeloma therapies. These cancers include, for the most part, hematologic malignancies such as acute leukemias and certain lymphomas. While there is no question about the role of alkylating agents and topoisomerase II inhibitors in this regard, further research is necessary to determine whether the excess of second cancers represents a direct consequence of lenalidomide use.
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Familial monoclonal gammopathy of undetermined significance and multiple myeloma: epidemiology, risk factors, and biological characteristics. Blood 2012; 119:5359-66. [PMID: 22354002 DOI: 10.1182/blood-2011-11-387324] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Monoclonal gammopathy of undetermined significance (MGUS), a precursor to multiple myeloma (MM), is one of the most common premalignant conditions in the general population. The cause of MGUS is largely unknown. Recent studies show that there is an increased prevalence of MGUS in blood relatives of persons with lymphoproliferative and plasma cell proliferative disorders, suggesting presence of shared underlying genetic influences. In the past few years, additional studies have examined risk factors and biologic characteristics that may contribute to the increased prevalence of MGUS among relatives of probands with MGUS, MM, and other blood malignancies. This article reviews the known epidemiology and risk factors for familial MGUS and myeloma, the risk of lymphoproliferative disorders and other malignancies among blood-relatives of patients with MGUS and MM, and discusses future directions for research.
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Goldin LR, Kristinsson SY, Liang XS, Derolf AR, Landgren O, Björkholm M. Familial aggregation of acute myeloid leukemia and myelodysplastic syndromes. J Clin Oncol 2011; 30:179-83. [PMID: 22162584 DOI: 10.1200/jco.2011.37.1203] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
PURPOSE Apart from rare pedigrees with multiple cases of acute myeloid leukemia (AML), there is limited data on familial aggregation of AML and myelodysplastic syndromes (MDSs) in the population. PATIENTS AND METHODS Swedish population-based registry data were used to evaluate risk of AML, MDS, and other malignancies among 24,573 first-degree relatives of 6,962 patients with AML and 1,388 patients with MDS compared with 106,224 first-degree relatives of matched controls. We used a marginal survival model to calculate familial aggregation. RESULTS AML and/or MDS did not aggregate significantly in relatives of patients with AML. There was a modest risk ratio (RR, 1.3; 95% CI, 0.9 to 1.8) in myeloproliferative/myeloid malignancies combined. The risks for any hematologic or any solid tumor were modestly but significantly increased. Relatives of patients with MDS did not show an increased risk for any hematologic tumors. In contrast, we found a significantly increased risk (RR, 6.5; 95% CI, 1.1 to 38.0) of AML/MDS and of all myeloid malignancies combined (RR, 3.1; 95% CI, 1.0 to 9.8) among relatives of patients diagnosed at younger than age 21 years. CONCLUSION We did not find evidence for familial aggregation of the severe end of the spectrum of myeloid malignancies (AML and MDS). The risks of myeloproliferative neoplasms were modestly increased with trends toward significance, suggesting a possible role of inheritance. In contrast, although limited in sample size, relatives of young patients with AML were at increased risk of AML/MDS, suggesting that germline genes may play a stronger role in these patients. The increased risk of all hematologic malignancies and of solid tumors among relatives of patients with AML suggests that genes for malignancy in general and/or other environmental factors may be shared.
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Affiliation(s)
- Lynn R Goldin
- Genetic Epidemiology Branch, DCEG, NCI, 6120 Executive Blvd, Room 7124, MSC 7236, Bethesda, MD 20892-7236, USA.
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Personal and family history of immune-related conditions increase the risk of plasma cell disorders: a population-based study. Blood 2011; 118:6284-91. [PMID: 21998210 DOI: 10.1182/blood-2011-04-347559] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The associations between immune-related conditions and multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS) have previously been investigated with inconsistent results. In a large population-based study, we identified 19 112 patients with MM, 5403 patients with MGUS, 96 617 matched control subjects, and 262 931 first-degree relatives. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for the association of MM and MGUS with immune-related conditions by use of logistic regression. A personal history of all infections combined was associated with a significantly increased risk of MM (OR = 1.2; 95% CI, 1.1-1.3), and a personal history of all conditions in the categories infections (OR = 1.6; 95% CI, 1.5-1.7), inflammatory conditions (OR = 1.4; 95% CI, 1.2-1.5), and autoimmune diseases (OR = 2.1; 95% CI, 1.9-2.4) was associated with a significantly increased risk of MGUS. Several specific immune-related conditions elevated the risk of MM and/or MGUS. A family history of autoimmune disease was associated with a significantly increased risk of MGUS (OR = 1.1; 95% CI, 1.00-1.2), but not MM. Our findings suggest that immune-related conditions and/or their treatment are of importance in the etiology of MGUS and possibly MM. The association of both personal and family history of autoimmune disease with MGUS indicates the potential for shared susceptibility for these conditions.
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Hanzis C, Ojha RP, Hunter Z, Manning R, Lewicki M, Brodsky P, Ioakimidis L, Tripsas C, Patterson CJ, Sheehy P, Treon SP. Associated malignancies in patients with Waldenström's macroglobulinemia and their kin. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2011; 11:88-92. [PMID: 21454200 DOI: 10.3816/clml.2011.n.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We examined the incidence of other malignancies in 924 Waldenström's Macroglobulinemia (WM) patients and their kin. A total of 225 (24.3%) patients had ≥1 additional malignancy, with 63% predating the WM diagnosis. The most common gender-adjusted malignancies were prostate (9.4%), breast (8.0%), non-melanoma skin (7.1%), hematologic (2.8%), melanoma (2.2%), lung (1.4%) and thyroid 1.1%). Among hematologic malignancies, all 13 cases of diffuse large B-cell lymphoma and 4 cases of acute myelogenous leukemia were diagnosed after WM, and were therapy-related. Familial WM subgroup analysis showed a higher incidence of prostate cancer (P=.046) in sporadic WM patients, while patients with familial WM had a higher incidence of lung cancer (P=.0043). An increased incidence of myeloid leukemias (P<.0001) was reported among kin of familial WM patients. These data reveal specific cancer associations with WM, and provide a basis for exploratory studies aimed at delineating a common genetic basis. Additionally, these studies suggest specific cancer clustering based on familial predisposition to WM.
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Affiliation(s)
- Christina Hanzis
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
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Boyd KD, Ross FM, Chiecchio L, Dagrada G, Konn ZJ, Tapper WJ, Walker BA, Wardell CP, Gregory WM, Szubert AJ, Davies FE, Morgan GJ. Gender disparities in the tumor genetics and clinical outcome of multiple myeloma. Cancer Epidemiol Biomarkers Prev 2011; 20:1703-7. [PMID: 21680536 DOI: 10.1158/1055-9965.epi-11-0157] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Several cancer types have differences in incidence and clinical outcome dependent on gender, but these are not well described in myeloma. The aim of this study was to characterize gender disparities in myeloma. METHODS We investigated the association of gender with the prevalence of tumor genetic lesions and the clinical outcome of 1,960 patients enrolled in the phase III clinical trial MRC Myeloma IX. Genetic lesions were characterized by FISH. RESULTS Disparities were found in the prevalence of primary genetic lesions with immunoglobulin heavy chain gene (IGH) translocations being more common in women (50% of female patients vs. 38% of male patients, P < 0.001) and hyperdiploidy being more common in men (50% female vs. 62% male, P < 0.001). There were also differences in secondary genetic events with del(13q) (52% female vs. 41% male, P < 0.001) and +1q (43% female vs. 36% male, P = 0.042) being found more frequently in female myeloma patients. Female gender was associated with inferior overall survival (median: 44.8 months female vs. 49.9 months male, P = 0.020). CONCLUSIONS We found gender-dependent differences in the prevalence of the primary genetic events of myeloma, with IGH translocations being more common in women and hyperdiploidy more common in men. This genetic background may impact subsequent genetic events such as +1q and del(13q), which were both more frequent in women. The higher prevalence of lesions associated with poor prognosis in the female myeloma population, such as t(4;14), t(14;16) and +1q, may adversely affect clinical outcome. IMPACT These differences suggest that gender influences the primary genetic events of myeloma.
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Affiliation(s)
- Kevin D Boyd
- The Institute of Cancer Research, Section of Haemato-Oncology, London, United Kingdom
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Weiss BM, Kuehl WM. Advances in understanding monoclonal gammopathy of undetermined significance as a precursor of multiple myeloma. Expert Rev Hematol 2011; 3:165-74. [PMID: 20473362 DOI: 10.1586/ehm.10.13] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Monoclonal gammopathy of undetermined significance (MGUS) affects at least 3% of the population above the age of 50 and is the precursor to multiple myeloma (MM), an incurable malignancy of plasma cells. Recent advances in MGUS include: an improved understanding of the pathogenesis of MGUS and its progression to MM, involving molecular events intrinsic to the malignant plasma cell as well as the microenvironment; novel techniques to assess risk for progression to MM using serum-free light-chain analysis and immunophenotyping; and a renewed interest in chemoprevention of MM. In the future, continued improvement in our understanding of MGUS will lead to the development of better biomarkers for prognosis and therapies for chemoprevention of MM.
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Affiliation(s)
- Brendan M Weiss
- Hematology-Oncology Service, Walter Reed Army Medical Center, 6900 Georgia Avenue N.W., Washington, DC 20307, USA.
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Hasskarl J, Ihorst G, De Pasquale D, Schröttner P, Zerweck A, Wäsch R, Engelhardt M. Association of multiple myeloma with different neoplasms: systematic analysis in consecutive patients with myeloma. Leuk Lymphoma 2010; 52:247-59. [DOI: 10.3109/10428194.2010.529207] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Churpek JE, Onel K. Heritability of hematologic malignancies: from pedigrees to genomics. Hematol Oncol Clin North Am 2010; 24:939-72. [PMID: 20816581 DOI: 10.1016/j.hoc.2010.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Many hematologic malignancies have an underlying heritable component. Although not as well characterized as the acquired genetic abnormalities that define important prognostic and therapeutic subgroups of myeloid and lymphoid neoplasms, investigations are beginning to unravel the role of germline genetic variation in the predisposition to hematologic malignancies. Information gained from the study of striking family pedigrees, epidemiologic data, and candidate genes are now being combined with unbiased genome-wide investigations to outline the network of genetic abnormalities that contribute to hematologic malignancy risk. This article reviews the current understanding of the heritability of hematologic malignancies in the genomics era.
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Affiliation(s)
- Jane E Churpek
- Section of Hematology/Oncology, Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
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Abstract
Multiple myeloma (MM) is the most common hematologic malignancy in blacks. Some prior studies suggest inferior survival in blacks; others suggest similar survival. Using the original 9 Surveillance, Epidemiology, and End Results registries, we conducted a large-scale population-based study including 5798 black and 28 939 white MM patients diagnosed 1973-2005, followed through 2006. Age-adjusted incidence rates, disease-specific survival, and relative survival rates were calculated by race, age, and time period of diagnosis. Mean age at diagnosis was 65.8 and 69.8 years for blacks and whites, respectively (P < .001). Incidence among blacks was m twice that among whites; this disparity was greater among patients < 50 years (P = .002). Over the entire study period, disease-specific and relative survival rates were higher in blacks than whites (P < .001). For whites, 5-year relative survival rates increased significantly 1973-1993 to 1994-1998 (26.3% to 30.8%; P < .001) and 1994-1998 to 1999-2005 (30.8% to 35.0%; P = .004). Survival improvements among blacks were smaller and nonsignificant (1973-1993 to 1999-2005: 31.0% to 34.1%; P = .07). We found (1) a younger age of onset among blacks; (2) better survival in blacks 1973-2005; and (3) significant survival improvement among whites over time, with smaller, nonsignificant change seen among blacks, possibly due to unequal access to and/or disparate responsiveness to novel therapies.
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Waxman AJ, Kuehl M, Balakumaran A, Weiss B, Landgren O. Smoldering (asymptomatic) multiple myeloma: revisiting the clinical dilemma and looking into the future. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2010; 10:248-57. [PMID: 20709660 PMCID: PMC6849209 DOI: 10.3816/clml.2010.n.053] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Recent studies show that multiple myeloma (MM) is consistently preceded by an asymptomatic precursor state. Smoldering MM (SMM) is a MM precursor defined by an M-protein concentration >or= 3 g/dL and/or >or= 10% bone marrow plasma cells, in the absence of end-organ damage. Compared with individuals diagnosed with monoclonal gammopathy of undetermined significance (MGUS), patients with SMM have a much higher annual risk of developing MM. However, based on clinical observations, the natural history of SMM varies greatly, from stable MGUS-like disease to highly progressive disease. Using conventional clinical markers, SMM patients can be stratified into 3 risk groups. Importantly, because of considerable molecular heterogeneity, we currently lack reliable markers to predict prognosis for individual SMM patients. Furthermore, until recently, potent drugs with reasonable toxicity profiles have not been available for the development of early MM treatment strategies. Consequently, current clinical guidelines emphasize the application of close clinical monitoring followed by treatment when the patient develops symptomatic MM. This review focuses on novel biomarkers, molecular profiles, and microenvironmental interactions of interest in myelomagenesis. We also discuss how the integration of novel biologic markers and clinical monitoring of SMM could facilitate the development of early treatment strategies for high-risk SMM patients in the future.
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Affiliation(s)
- Adam J. Waxman
- Medical Oncology Branch, National Cancer Institute,
Bethesda, MD
- Clinical Research Training Program, NIH Clinical Center,
Bethesda, MD
| | - Michael Kuehl
- The Genetics Branch, National Cancer Institute, Bethesda,
MD
| | - Arun Balakumaran
- National Institute of Dental and Craniofacial Research,
Bethesda, MD
| | - Brendan Weiss
- Medical Oncology Branch, National Cancer Institute,
Bethesda, MD
- Hematology-Oncology Service, Department of Medicine, Walter
Reed Army Medical Center, Washington, DC
| | - Ola Landgren
- Medical Oncology Branch, National Cancer Institute,
Bethesda, MD
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