Role of immune stimulation in the etiology of multiple myeloma: A case control study

Abstract

A hospital-based case-control study of 153 multiple myeloma (MM) cases and 459 controls was conducted to evaluate the hypothesis that chronic or frequent infections or allergic and autoimmune diseases might be of higher prevalence in individuals who develop MM. Information was obtained by direct interviews of subjects. Controls were matched to cases on age, sex, race, and hospital. "Immune-stimulating conditions" included chronic infections such as pyelonephritis, urinary tract infections (UTIs), prostatitis, rheumatoid arthritis and other collagen vascular diseases, allergies, bronchitis, tuberculosis, cholecystitis, diverticulitis, and osteomyelitis. The overall odds ratio (OR) (odds of history of immune-stimulating conditions in cases versus controls) was 0.4 (95% confidence interval = 0.3-0.7) which suggested that cases had significantly less immune-stimulating conditions than did controls. The exposure rate for these conditions was high for cases (0.7) as well as for all control groups (0.8). These findings suggest that immune-stimulating conditions alone are not the causative factor in the etiology of MM, though they may play a role in the predisposed individual.

Multiple myeloma: A review of the epidemiologic literature

“…Findings for allergic conditions are inconsistent and do not support a causal relationship, as several studies have reported associations below, 24,47,87,[279][280][281] while others have reported associations above the null. 46,83,131,202,[282][283][284] Pearce et al 83 reported a marginally significant positive association (OR 5 1.9, 95% CI: 1.0-3.5) of multiple myeloma with hay fever, a finding not replicated by others.…”

“…Some studies have reported increased risk among patients with a history of rheumatoid arthritis, 24,83,202,[290][291][292] while others have reported relative risks below 1.0. 87,280,281,289,[293][294][295] The largest case-control studies that evaluated rheumatoid arthritis all reported nonsignificant relative risks below 1.0. 87,280,281,293 In particular, Lewis et al In an Australian cohort study, risk of multiple myeloma was significantly elevated (SIR 5 12.1, 95% CI: 2.50-35.4; 3 observed cases) among persons with AIDS.…”

“…87,280,281,289,[293][294][295] The largest case-control studies that evaluated rheumatoid arthritis all reported nonsignificant relative risks below 1.0. 87,280,281,293 In particular, Lewis et al In an Australian cohort study, risk of multiple myeloma was significantly elevated (SIR 5 12.1, 95% CI: 2.50-35.4; 3 observed cases) among persons with AIDS. 296 An increased incidence following a diagnosis of AIDS (SIR 5 4.5, 95% CI: 0.9-13.2) was reported in an earlier US and Puerto Rican AIDS registry study.…”

Risk of monoclonal gammopathy of undetermined significance: A case-referent study

“…role of occupational exposure [ 1,2,4,8,9], and of chronic antigenic stimulation [ 1,2,5,10] in multiple myeloma, using the case-control method, this is the first study to consider these risk factors in MGUS. Despite the limitations of case-control studies [6], the observation of significant associations with some occupational exposure and with overall chronic antigenic stimulation suggests that these factors may play an important role in inducing MGUS.…”

Prior Autoimmune Disease and Risk of Monoclonal Gammopathy of Undetermined Significance and Multiple Myeloma: A Systematic Review

“…For those studies in which the risk measurement was not calculated but where sufficient data were presented, a fixed effects model was used to calculate the unadjusted RR (22)(23)(24)(25). For those studies meeting the inclusion criteria but which reported unadjusted risk measurements, RR, OR, and SIRs were extracted (22)(23)(24)(25)(26).…”