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Liang H, Li Y, Liu C, Wang H, Ren Y, Sun F, Xue M, Zhu G, Zhou Y. Raman spectroscopy of dried serum for the detection of rapid noninvasive multiple myeloma. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2025; 328:125448. [PMID: 39579726 DOI: 10.1016/j.saa.2024.125448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Revised: 11/10/2024] [Accepted: 11/13/2024] [Indexed: 11/25/2024]
Abstract
Raman spectroscopy has recently emerged as an attractive focus of research interest in studies of hematological diseases. However, comprehensive Raman spectral analyses of serum samples from patients with multiple myeloma (MM) or other forms of lymphatic neoplastic disease are lacking. In this study, laser Raman spectroscopy and orthogonal partial least-squares discrimination analysis (OPLS-DA) were employed to develop a simple, noninvasive approach to MM diagnosis based on dried serum samples. To that end, systematic OPLS-DA analyses of dried serum from 35 patients with MM and 13 healthy controls were performed, revealing clear differences between these two groups in terms of the resultant serum spectral data. Specifically, significant reductions in the intensities of Raman peaks corresponding to nucleic acids (726, 781, 1579 cm-1), proteins (621, 1603, 1616 cm-1), lipids (1437, 1443, 1446 cm-1) and carotenoids (957, 1160, 1520 cm-1) were observed in MM, together with increases in the intensities of peaks corresponding to carbohydrates (920, 1123 cm-1) and collagen (1345 cm-1). Through combined analyses of serological indices associated with metabolic activity, MM patients were confirmed to exhibit elevated serum glucose levels and decreased levels of high-density lipoprotein cholesterol. These results offer a spectroscopic foundation for the relationships between MM classification and serological testing data, offering new evidence that can guide the early and efficient identification and characterization of this deadly cancer type. This exploratory study thus offers insight into the potential utility of Raman spectroscopy as a tool for the noninvasive detection of specific subtypes of MM.
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Affiliation(s)
- Haoyue Liang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China
| | - Yihan Li
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China
| | - Chang Liu
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China
| | - Haoyu Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China
| | - Yansong Ren
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China
| | - Fanfan Sun
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China
| | - Mei Xue
- School of Medical Technology, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Guoqing Zhu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China.
| | - Yuan Zhou
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China.
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2
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Sardeshmukh S, Deshmukh V, Godse V, Gujar S, Dalvi S, Kulkarni S, Bhuvad S, Sardeshmukh N, Sardeshmukh B, Deshpande D, Awalkanthe V, Salunkhe A, Redekar A, Vaidya S, Chavan S. Ayurvedic perspective of dietary risk factors of colorectal cancers - A hospital-based case control study. J Ayurveda Integr Med 2024; 15:100969. [PMID: 39577139 PMCID: PMC11617946 DOI: 10.1016/j.jaim.2024.100969] [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: 06/30/2023] [Revised: 02/20/2024] [Accepted: 05/13/2024] [Indexed: 11/24/2024] Open
Abstract
BACKGROUND The rising prevalence of colorectal cancer (CRC) may be attributed to various nutritional and behavioural factors, making both factors as important topics for discussion to the layman and the oncology community. OBJECTIVE To explore additional dietary risk factors, other than those already known, according to the Ayurvedic perspective in CRC patients. METHODS Detail dietary data was collected from 420 patients of CRC and 116 healthy volunteers registered at our institute with the help of a food frequency questionnaire. Descriptive analysis was done by plotting radar charts, whereas the logistic regression models were used to calculate the adjusted Odd Ratios (ORs) associated with consumption of green chilli, red chilli powder and curd, individually and in combinations. RESULTS The controls in the present study were younger, had more males, the majority of them belonged to middle- and lower-income groups and had a family history of cancer as compared with cohort of case studies. Green chilli consumption was found to be the maximum within the lower-income group (n = 18, 66.67%), while that of red chilli (n = 150, 48.23%), and curd (n = 107, 34.04%) within the middle class. Maximum consumption of green chillies (Males n = 48, 29.27%; Females n = 36, 21.95%), red chillies (Males n = 40, 29.85%; Females n = 16, 24.61%) and curd (Males n = 31, 28.97%) was observed in the age group 46 to 60 irrespective of sex. Tobacco was found to be the most common addiction in all groups. The maximum number of patients frequently consuming these three dietary items presented majorly with rectal cancer, and liver metastasis and were in advanced grade and stage of cancer. Curd and curd with red chilli powder had a significant association with the development of CRC with an OR of 2.7280 (95% CI 1.6346 to 4.5531) and 5.0806 (95% CI 2.4015 to 10.7485), respectively, which was highly significant (p < 0.0001). Green chilli was notably an associated risk with an OR of 2.0095 (95% CI 1.3258 to 3.0458), which was also statistically significant (p = 0.001). Red chilli powder and green chilli with curd had ORs as 1.6917 (95% CI 1.1105 to 2.5771) and 2.1778 (95% CI 1.1591 to 4.0918) with p = 0.0144 and 0.0156, respectively. CONCLUSION In the present study, green chilli, red chilli, and curd are identified as additional dietary risk factors for colorectal cancers, owing to their ability to produce chronic inflammation leading to various inflammatory conditions including cancer.
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Affiliation(s)
- Sadanand Sardeshmukh
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
| | - Vineeta Deshmukh
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India.
| | - Vasanti Godse
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
| | - Shweta Gujar
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
| | - Sneha Dalvi
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
| | - Swapna Kulkarni
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
| | - Sushama Bhuvad
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
| | - Nilambari Sardeshmukh
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
| | - Bhagyashree Sardeshmukh
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
| | - Dhananjay Deshpande
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
| | - Vinita Awalkanthe
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
| | - Amruta Salunkhe
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
| | - Anita Redekar
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
| | - Suchita Vaidya
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
| | - Sandeep Chavan
- Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Kesnand Road, Wagholi, Pune, Maharashtra, 412207, India
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Banerjee R, Biru Y, Cole CE, Faiman B, Midha S, Ailawadhi S. Disparities in relapsed or refractory multiple myeloma: recommendations from an interprofessional consensus panel. Blood Cancer J 2024; 14:149. [PMID: 39191731 PMCID: PMC11350150 DOI: 10.1038/s41408-024-01129-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 08/12/2024] [Accepted: 08/14/2024] [Indexed: 08/29/2024] Open
Abstract
Many studies have documented racial, socioeconomic, geographic, and other disparities for United States (US) patients with multiple myeloma pertaining to diagnosis and frontline management. In contrast, very little is known about disparities in the management of relapsed/refractory multiple myeloma (RRMM) despite a plethora of novel treatment options. In this review, we discuss the manifestations of disparities in RRMM and strategies to mitigate their impact. Immunomodulatory drugs can create disparities on many axes, for example inappropriately low dosing due to Duffy-null status as well as time toxicity and financial toxicity from logistical hurdles for socioeconomically vulnerable patients. Access to myeloma expertise at high-volume centers is a critical consideration given the disconnect between how drugs like carfilzomib and dexamethasone are prescribed in trials versus optimized in real-world practice to lower toxicities. Disparities in chimeric antigen receptor T-cell therapy and bispecific antibody therapy span across racial, ethnic, and socioeconomic lines in large part due to their limited availability outside of high-volume centers. Another insidious source of disparities is supportive care in RRMM, ranging from inadequate pain control in Black patients to limited primary care provider access in rural settings. We discuss the rationales and evidence base for several solutions aimed at mitigating these disparities: for example, (1) bidirectional co-management with community-based oncologists, (2) screening for risk factors based on social determinants of health, (3) strategies to build patient trust with regard to clinical trials, and (4) longitudinal access to a primary care provider. As the treatment landscape for RRMM continues to expand, these types of efforts by the field will help ensure that this landscape is equally accessible and traversable for all US patients.
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Affiliation(s)
- Rahul Banerjee
- Fred Hutchinson Cancer Center, Seattle, WA, USA.
- University of Washington, Seattle, WA, USA.
| | - Yelak Biru
- International Myeloma Foundation, Los Angeles, CA, USA
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Engelhardt M, Kortüm KM, Goldschmidt H, Merz M. Functional cure and long-term survival in multiple myeloma: how to challenge the previously impossible. Haematologica 2024; 109:2420-2435. [PMID: 38356448 PMCID: PMC11290544 DOI: 10.3324/haematol.2023.283058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/06/2024] [Indexed: 02/16/2024] Open
Abstract
Multiple myeloma (MM) is a heterogeneous disease with survival ranging from months to decades. The goal of 'cure' remains elusive for most patients, but has been shown to be possible, with durable remission and a transition to a plateau phase (analogous to monoclonal gammopathy of uncertain significance/smoldering myeloma). In this review, two representative cases set the stage to illustrate how this might be possible and what still needs to be determined to achieve functional disease control over a prolonged period. Several developments have emerged, such as improved diagnostics including the definitions and use of SLiM-CRAB criteria and measurable residual disease (MRD) with whole-genome/single-cell sequencing as well as other correlates to better understand disease biology. These advances enable earlier detection, more accurate risk stratification and improved personalized treatment strategies by facilitating analysis of genetic alterations and clonal heterogeneity. Whole-genome sequencing may also identify driver mutations and modes of resistance to immunotherapies as well as other targeted therapies. Today, induction with a CD38 antibody, proteasome inhibitor, immunomodulatory drug, and dexamethasone, potentially followed by autologous stem cell transplantation and lenalidomide maintenance, can be considered standard of care for transplant-eligible (TE) patients with newly diagnosed MM (NDMM). That prolonged disease control and functional cure can be achieved in non-transplant-eligible (NTE) patients is currently emerging as a distinct possibility: data from phase III trials that incorporate a CD38 antibody into the treatment of NTE NDMM patients demonstrate impressive MRD negativity rates that appear sustained over several years. While the long-term durability of chimeric antigen receptor T cells, bi-specific antibodies and other immunotherapies are being evaluated, several clinical trials are now investigating their role in frontline treatment for TE and NTE patients. These trials will address whether chimeric antigen receptor T-cell therapy will replace autologous stem cell transplantation and whether such immunotherapies will represent a truly curative option. We conclude that while cure remains elusive, the concept of operational or functional cure provides a new benchmark to strive for and is an emerging area of active and potentially achievable clinical research for MM.
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Affiliation(s)
- Monika Engelhardt
- Department of Medicine I Hematology and Oncology, Medical Center University of Freiburg, Faculty of Medicine, Comprehensive Cancer Center Freiburg (CCCF).
| | - K Martin Kortüm
- Department of Medicine II, University Hospital of Würzburg, Würzburg
| | - Hartmut Goldschmidt
- University Hospital Heidelberg and the National Center for Tumor Diseases, Heidelberg
| | - Maximilian Merz
- Department of Hematology, Cell therapy and Hemostaseology, University Hospital Leipzig, Leipzig.
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5
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Zhang CY, Zhang D, Sun WR, Tang HL, Tian B, Hu LH, Hu WY, Gao YY, Li MY, Xiao WT, Gao S, Gao GX. Causal associations between the gut microbiota and multiple myeloma: a two-sample Mendelian randomization study. Front Nutr 2024; 11:1400116. [PMID: 38946785 PMCID: PMC11212462 DOI: 10.3389/fnut.2024.1400116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/28/2024] [Indexed: 07/02/2024] Open
Abstract
Background Previous observational studies have indicated a potential association between the gut microbiota and multiple myeloma (MM). However, the relationship between the gut microbiota and MM remains unclear. This study aimed to ascertain the existence of a causal link between the gut microbiota and MM. Methods To investigate the potential causal relationship between gut microbiota and MM, a two-sample Mendelian randomization (MR) analysis was conducted. Exposure data was obtained from the MiBioGen consortium, which provided genetic variants associated with 211 bacterial traits. MM outcome data was obtained from the FinnGen consortium. The selection of Single nucleotide polymorphisms estimates was performed through meta-analysis using inverse-variance weighting, and sensitivity analyses were conducted using weighted median, MR Egger, Simple mode, and MR-PRESSO. Results The results of the study demonstrated a significant positive correlation between the genus Eubacterium ruminantium group and the risk of MM (OR 1.71, 95% CI 1.21 to 2.39). Conversely, the genus: Dorea (OR 0.46, 95% CI 0.24 to 0.86), Coprococcus1 (OR 0.47, 95% CI 0.22 to 1.00), RuminococcaceaeUCG014 (OR 0.57, 95% CI 0.33 to 0.99), Eubacterium rectale group (OR 0.37, 95% CI 0.18 to 0.77), and order: Victivallales (OR 0.62, 95% CI 0.41-0.94), class: Lentisphaeria (OR 0.62, 95% CI 0.41 to 0.94), exhibited a negative association with MM. The inverse variance weighting analysis provided additional support for these findings. Conclusion This study represents an inaugural exploration of MR to investigate the connections between gut microbiota and MM, thereby suggesting potential significance for the prevention and treatment of MM.
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Affiliation(s)
- Chun-Yan Zhang
- Department of Hematology, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Dong Zhang
- Department of Plastic Surgery, Tangdu Hospital, Air Force Military Medical University, Xi’an, China
| | - Wen-Rui Sun
- Department of Hematology, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Hai-Long Tang
- Department of Hematology, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Biao Tian
- Department of Hematology, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Li-Hong Hu
- Department of Hematology, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Wu-Yue Hu
- Department of Hematology, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Ya-Ya Gao
- Department of Hematology, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Miao-Yu Li
- Department of Hematology, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Wan-Ting Xiao
- Department of Hematology, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Shan Gao
- Department of Hematology, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Guang-Xun Gao
- Department of Hematology, Xijing Hospital, Air Force Military Medical University, Xi’an, China
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6
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Feng Z, Liao M, Guo X, Li L, Zhang L. Effects of immune cells in mediating the relationship between gut microbiota and myelodysplastic syndrome: a bidirectional two-sample, two-step Mendelian randomization study. Discov Oncol 2024; 15:199. [PMID: 38819469 PMCID: PMC11143100 DOI: 10.1007/s12672-024-01061-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 05/27/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND The definitive establishment of a causal relationship between gut microbiota and myelodysplastic syndrome (MDS) has not been achieved. Furthermore, the involvement of immune cells in mediating the connection between gut microbiota and MDS is presently unclear. METHODS To elucidate the bidirectional correlation between gut microbiota and MDS, as well as to investigate the mediating role of immune cells, a bidirectional two-sample, two-step Mendelian randomization (MR) study was conducted. Summary statistics were obtained from genome-wide association studies (GWAS), including MDS (456,348 individuals), gut microbiota (18,340 individuals), and 731 immune cells signatures (3757 individuals). RESULTS Genetically predicted eight gut microbiota traits were significantly associated with MDS risk, but not vice versa. Through biological annotation of host-microbiome shared genes, we found that immune regulation may mediate the impact of gut microbiota on MDS. Subsequently, twenty-three immunophenotypes that exhibited significant associations with MDS risk and five of these immunophenotypes were under the causal influence of gut microbiota. Importantly, the causal effects of gut microbiota on MDS were significantly mediated by five immunophenotypes, including CD4 +T cell %leukocyte, CD127 on CD45RA - CD4 not regulatory T cell, CD45 on CD33 + HLA DR + WHR, CD33 on basophil, and Monocyte AC. CONCLUSIONS Gut microbiota was causally associated with MDS risk, and five specific immunophenotypes served as potential causal mediators of the effect of gut microbiota on MDS. Understanding the causality among gut microbiota, immune cells and MDS is critical in identifying potential targets for diagnosis and treatment.
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Affiliation(s)
- Zuxi Feng
- Department of Hematology, Lanzhou University Second Hospital, Lanzhou, 730000, China
| | - Minjing Liao
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Xuege Guo
- Department of Hematology, Lanzhou University Second Hospital, Lanzhou, 730000, China
| | - Lijuan Li
- Department of Hematology, Lanzhou University Second Hospital, Lanzhou, 730000, China.
| | - Liansheng Zhang
- Department of Hematology, Lanzhou University Second Hospital, Lanzhou, 730000, China.
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7
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Joseph JM, Hillengass J, Tang L, Lesokhin AM, Landgren O, Usmani SZ, Moysich KB, McCann SE, Shah UA. Dietary risk factors for monoclonal gammopathy of undetermined significance in a racially diverse population. Blood Adv 2024; 8:538-548. [PMID: 38055924 PMCID: PMC10835229 DOI: 10.1182/bloodadvances.2023011608] [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: 09/06/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023] Open
Abstract
ABSTRACT Monoclonal gammopathy of undetermined significance (MGUS), a precursor of multiple myeloma, is associated with shorter lifespan and cardiac, renal, neurologic, and immune-related comorbidities. There is little known about modifiable risk factors for this condition. To determine whether the risk of MGUS is associated with dietary factors in a racially diverse population, we conducted a US population-based case-control study from the National Health and Nutrition Examination Survey (1988-2004), which included 373 individuals with MGUS and 1406 matched controls. Diet was characterized by one 24-hour dietary recall, with gram intake of individual foods and beverages aggregated into groups. Unconditional multivariable logistic regressions were used to model associations between intake of several food groups and MGUS, with odds ratios (ORs) and 95% confidence intervals (CIs) reported for the highest relative to the lowest quantile of intake. Daily gram intake of several food and beverage groups were significantly associated with MGUS. MGUS was inversely associated with whole-grain bread, oats, and rice (OR, 0.70; 95% CI, 0.48-1.00; P < .05), fruits (excluding juice) and vegetables (OR, 0.69; 95% CI, 0.52-0.93; P = .02), vegetables (OR, 0.75; 95% CI, 0.56-0.99; P < .05), tomatoes (OR, 0.72; 95% CI, 0.51-1.00; P < .05), and cruciferous vegetables (OR, 0.44; 95% CI, 0.26-0.74; P < .01). Direct associations were observed for sugar-sweetened beverages (OR, 1.34; 95% CI, 1.00-1.78; P < .05), sugar-sweetened soft drinks (OR, 1.41; 95% CI, 1.01-1.96; P = .04), and artificially sweetened soft drinks (OR, 1.55; 95% CI, 1.04-2.33; P = .03). Our study shows that diet is potentially a modifiable risk factor for MGUS.
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Affiliation(s)
- Janine M. Joseph
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Jens Hillengass
- Myeloma Section, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Li Tang
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Alexander M. Lesokhin
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ola Landgren
- Myeloma Service, Department of Medicine, Sylvester Comprehensive Cancer Center at the University of Miami, Miami, FL
| | - Saad Z. Usmani
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kirsten B. Moysich
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Susan E. McCann
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Urvi A. Shah
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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8
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Castro F, Parikh R, Eustaquio JC, Derkach A, Joseph JM, Lesokhin AM, Usmani SZ, Shah UA. Pre-diagnosis dietary patterns and risk of multiple myeloma in the NIH-AARP diet and health study. Leukemia 2024; 38:438-441. [PMID: 38158443 PMCID: PMC10919351 DOI: 10.1038/s41375-023-02132-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/15/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Francesca Castro
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Richa Parikh
- Department of Hematology/Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Jelyn C Eustaquio
- Jacobs School of Medicine and Biomedical Science, University at Buffalo, Buffalo, NY, USA
| | - Andriy Derkach
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Janine M Joseph
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Alexander M Lesokhin
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Saad Z Usmani
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Urvi A Shah
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
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9
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Andreazzoli F, Levy Yurkovski I, Ben-Arye E, Bonucci M. Conceptualizing an Integrative Multiple Myeloma Care: The Role of Nutrition, Supplements, and Complementary Modalities. Nutrients 2024; 16:237. [PMID: 38257130 PMCID: PMC10818534 DOI: 10.3390/nu16020237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Multiple Myeloma (MM) is the second most prevalent hematologic malignancy, and its incidence has been increasing enormously in recent years. The prognosis of MM has changed radically with the introduction of new drugs that have improved life expectancy; recurrences are a common occurrence during the course of the disease and are characterized by an increase in refractory to treatment. Moreover, MM patients are challenged by quality of life-related concerns while limited conventional therapy may be offered. This includes bone pain and dialysis due to the complications of acute renal failure. We, therefore, believe that it is very important to add new treatment modalities, including supplements, nutritional modifications, acupuncture, and mind-body therapies, with the goal of improving treatment tolerance, effectiveness, and patients' quality of life. Moreover, many patients use some of these supplements on their own, in the hope of reducing the side effects, so it is even more important to know their action and potential. The purpose of this review is to illustrate all these strategies potentially available to enrich our approach to this, to date, incurable disease.
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Affiliation(s)
- Francesca Andreazzoli
- Department of Hematology, Versilia’s Hospital, Viale Aurelia, 335, 55049 Camaiore, Italy
| | - Ilana Levy Yurkovski
- Hematology Unit, Bnai Zion Medical Center, Haifa 3339419, Israel
- Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3109601, Israel;
- Complementary and Integrative Medicine Service, Bnai Zion Medical Center, Haifa 3339419, Israel
| | - Eran Ben-Arye
- Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3109601, Israel;
- Integrative Oncology Program, The Oncology Service, Lin Carmel, and Zebulun Medical Centers, Clalit Health Services, Haifa 3535152, Israel
| | - Massimo Bonucci
- Artoi Foundation, Via Ludovico Micara, 73, 00165 Rome, Italy;
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10
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Shah UA, Moshier E, Derkach A, Huang Y, Mailankody S, Tan CR, Maclachlan K, Hultcrantz M, Korde N, Hassoun H, Thibaud S, Sanchez L, Rodriguez C, Richard S, Richter J, Rossi A, Cho HJ, Lesokhin A, Chari A, Usmani SZ, Jagannath S, Parekh S, Gallagher EJ. Prevalence and impact of diabetes on survival of patients with multiple myeloma in different racial groups. Blood Adv 2024; 8:236-247. [PMID: 37772981 PMCID: PMC10918423 DOI: 10.1182/bloodadvances.2023010815] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 09/30/2023] Open
Abstract
ABSTRACT Multiple myeloma (MM) is twice as common in Black individuals compared with in White individuals, and diabetes mellitus (DM) disproportionately affects Black patients. Although numerous studies have shown a correlation between DM and MM, this has not been studied in the context of race and in vivo mechanisms. We conducted a retrospective clinical study of 5383 patients with MM of which 15% had DM (White, 12% and Black, 25%). Multivariable Cox models showed reduced overall survival (OS) for patients with DM (hazard ratio, 1.27; 95% confidence interval, 1.11-1.47; P < .001). This appeared to be driven by a marked difference in OS between White patients with and without DM but not in Black patients. In contrast, obesity was associated with better OS in Black patients but not in White patients. To complement this analysis, we assessed MM growth in a genetically engineered immunocompromised nonobese diabetic (Rag1-/-/muscle creatinine kinase promoter expression of a human IGF1R [M] with a lysine [K] to arginine [R] point mutation) mouse model to evaluate the mechanisms linking DM and MM. MM.1S xenografts grew in more Rag1-/-/MKR mice and grew more rapidly in the Rag1-/-/MKR mice compared with in controls. Western blot analysis found that MM1.S xenografts from Rag1-/-/MKR mice had higher phosphorylated S6 ribosomal protein (Ser235/236) levels, indicating greater activation of the mammalian target of rapamycin pathway. Our study is, to our knowledge, the first to evaluate racial differences in DM prevalence and survival in MM, as well as the effect of DM on tumor growth in mouse models. Our results suggest that DM may contribute to the higher incidence of MM in Black patients; and to improve survival in MM, DM management cannot be ignored.
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Affiliation(s)
- Urvi A. Shah
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Erin Moshier
- Department of Population Health Science and Policy, Mount Sinai Health System, New York, NY
| | - Andriy Derkach
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yuanhui Huang
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Sham Mailankody
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Carlyn R. Tan
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Kylee Maclachlan
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Malin Hultcrantz
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Neha Korde
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Hani Hassoun
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Santiago Thibaud
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Larysa Sanchez
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Cesar Rodriguez
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Shambavi Richard
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Joshua Richter
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Adriana Rossi
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Hearn Jay Cho
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Alexander Lesokhin
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Ajai Chari
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Saad Z. Usmani
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sundar Jagannath
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Samir Parekh
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Emily J. Gallagher
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY
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11
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Golombick T, Ramakrishna R, Manoharan A. Regression of Intermediate-High Risk Monoclonal Gammopathy of Undetermined Significance (MGUS) With Long-term Use of Curcumin: A Case Report. Integr Cancer Ther 2024; 23:15347354241242099. [PMID: 38529782 DOI: 10.1177/15347354241242099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
Patients with intermediate-high risk MGUS are not offered therapeutic options to date and standard of care remains observation with re-evaluations of the patient every 3 to 6 months. Given the persistent risk of progression as well as potential complications experienced by some, and anxiety experienced by most patients, early intervention with non-toxic curcumin, aimed at potentially slowing down or stopping disease progression might be therapeutic. We present here an intermediate-high risk MGUS patient who has been taking curcumin for 16 years and has shown a decrease in disease markers and an increase in uninvolved immunoglobulins, adding to the body of evidence of benefit of curcumin to MGUS patients.
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Affiliation(s)
- Terry Golombick
- Southern Sydney Haematology, Sydney, NSW, Australia
- University of Wollongong, Sydney, NSW, Australia
| | - Rajeev Ramakrishna
- Southern Sydney Haematology, Sydney, NSW, Australia
- University of Wollongong, Sydney, NSW, Australia
| | - Arumugam Manoharan
- Southern Sydney Haematology, Sydney, NSW, Australia
- University of Wollongong, Sydney, NSW, Australia
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12
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Choa R, Panaroni C, Bhatia R, Raje N. It is worth the weight: obesity and the transition from monoclonal gammopathy of undetermined significance to multiple myeloma. Blood Adv 2023; 7:5510-5523. [PMID: 37493975 PMCID: PMC10515310 DOI: 10.1182/bloodadvances.2023010822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023] Open
Abstract
The overweight/obesity epidemic is a serious public health concern that affects >40% of adults globally and increases the risk of numerous chronic diseases, such as type 2 diabetes, heart disease, and various cancers. Multiple myeloma (MM) is a lymphohematopoietic cancer caused by the uncontrolled clonal expansion of plasma cells. Recent studies have shown that obesity is a risk factor not only for MM but also monoclonal gammopathy of undetermined significance (MGUS), a precursor disease state of MM. Furthermore, obesity may promote the transition from MGUS to MM. Thus, in this review, we summarize the epidemiological evidence regarding the role of obesity in MM and MGUS, discuss the biologic mechanisms that drive these disease processes, and detail the obesity-targeted pharmacologic and lifestyle interventions that may reduce the risk of progression from MGUS to MM.
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Affiliation(s)
- Ruth Choa
- Center for Multiple Myeloma, Massachusetts General Hospital, Boston, MA
| | - Cristina Panaroni
- Center for Multiple Myeloma, Massachusetts General Hospital, Boston, MA
| | - Roma Bhatia
- Center for Multiple Myeloma, Massachusetts General Hospital, Boston, MA
| | - Noopur Raje
- Center for Multiple Myeloma, Massachusetts General Hospital, Boston, MA
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13
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Castro F, Parikh R, Eustaquio JC, Derkach A, Joseph JM, Lesokhin AM, Usmani SZ, Shah UA. Pre-Diagnosis Dietary Patterns and Risk of Multiple Myeloma in the NIH-AARP Diet and Health Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.20.23295639. [PMID: 37790335 PMCID: PMC10543062 DOI: 10.1101/2023.09.20.23295639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background Despite patient interest in knowing whether diet is linked to multiple myeloma (MM), there is limited research on dietary patterns and MM risk. Two studies have assessed this risk, albeit with a small number of MM cases. The EPIC-Oxford cohort and Oxford Vegetarian study (65 MM cases) showed that fish eaters, vegetarians and vegans had significantly reduced MM risk compared to meat eaters. The Nurses' Health Study and Health Professionals Follow-up Study (478 MM cases) showed a significantly increased MM risk in men with Empirical Dietary Inflammatory Pattern. Methods The NIH-AARP Diet and Health study is a prospective cohort of 567,169 persons who completed a food frequency questionnaire in 1995-1996 and were followed until December 2011. Healthy Eating Index-2015 (HEI-2015), Healthy Diet Score (HDS), alternate Mediterranean Diet (aMED) and healthful Plant-based Diet Index (hPDI) scores were calculated using a priori defined methods and grouped into quartiles, with higher scores reflecting healthier eating patterns. We prospectively evaluated the association between pre-diagnosis dietary patterns and MM incidence in this cohort. Hazard ratios (HR) and 95% confidence intervals (95%CI) were estimated using multivariate Cox proportional hazards models adjusted for age at study entry, sex, race, body mass index, education, and total energy intake (by residual method). Sensitivity analysis was conducted to assess reverse causality by excluding MM cases diagnosed within one year of follow-up. Results Among 392,589 participants (after exclusions), a total of 1,366 MM cases (59% males; 92% non-Hispanic whites) were identified during the follow-up period. Analysis revealed a significant association between hPDI scores and reduced MM risk (highest vs lowest quartile, HR 0.85; 95%CI 0.73-1.0; p=0.043) (Table). In sensitivity analysis (1,302 MM cases), the association was no longer significant (HR 0.87; 95%CI 0.74-1.03; p 0.09) but trended in the same direction. This may be due to small sample size, given MM is a rare disease. HEI-2015, HDS and aMED scores were not associated with MM risk. Conclusions A healthful plant-based diet was associated with reduced MM risk in the NIH-AARP cohort. These results will help oncologists and patients make informed choices about their diet. To our knowledge, this is the largest epidemiologic study to date assessing pre-diagnosis dietary patterns and MM risk.
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Affiliation(s)
- Francesca Castro
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center
| | - Richa Parikh
- Department of Hematology/Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | | | - Andriy Derkach
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center
| | - Janine M. Joseph
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center
| | - Alexander M. Lesokhin
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
| | - Saad Z. Usmani
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
| | - Urvi A. Shah
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
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