Tobacco Use, Body Mass Index, and the Risk of Leukemia and Multiple Myeloma: A Nationwide Cohort Study in Sweden

Fernberg, Pia; Odenbro, Åsa; Bellocco, Rino; Boffetta, Paolo; Pawitan, Yudi; Zendehdel, Kazem; Adami, Johanna

doi:10.1158/0008-5472.can-07-0274

Cited by 69 publications

(59 citation statements)

References 28 publications

(29 reference statements)

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“…The consistency of our findings with previous cohort studies (5-7), which are less susceptible to these design limitations, argue against bias as a major explanation for our findings. In conclusion, the totality of evidence from our pooled analysis confirms that smoking is not associated with multiple myeloma.…”

Section: Discussionsupporting

confidence: 83%

A Pooled Analysis of Cigarette Smoking and Risk of Multiple Myeloma from the International Multiple Myeloma Consortium

Andreotti

Birmann

Cozen

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Past investigations of cigarette smoking and multiple myeloma have been underpowered to detect moderate associations, particularly within subgroups. To clarify this association we conducted a pooled analysis of nine case-control studies in the International Multiple Myeloma Consortium, with individual-level questionnaire data on cigarette smoking history and other covariates. Methods Using a pooled population of 2,670 cases and 11,913 controls, we computed odds ratios (ORs) and 95% confidence intervals (CIs) relating smoking to multiple myeloma risk using unconditional logistic regression adjusting for gender, age group, race, education, body mass index, alcohol consumption, and study center. Results Neither ever smokers (OR=0.95, 95% CI 0.87-1.05), current smokers (OR=0.82, 95% CI 0.73-0.93), nor former smokers (OR=1.03, 95% CI 0.92-1.14) had increased risks of multiple myeloma compared to never smokers. Analyses of smoking frequency, pack-years, and duration did not reveal significant or consistent patterns, and there was no significant effect modification by subgroups. Conclusion Findings from this large pooled analysis do not support the hypothesis of cigarette smoking as a causal factor for multiple myeloma. Impact Cigarette smoking is one of the most important risk factors for cancer, but the association with multiple myeloma was inconclusive. This study had excellent power to detect modest associations, and had individual-level data to evaluate confounding and effect modification by potentially important factors that were not evaluated in previous studies. Our findings confirm that smoking is not a risk factor for multiple myeloma.

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Section: Discussionsupporting

confidence: 83%

A Pooled Analysis of Cigarette Smoking and Risk of Multiple Myeloma from the International Multiple Myeloma Consortium

Andreotti

Birmann

Cozen

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…The extent to which this captures the actual burden of comorbid disease in our population is unknown because we were limited to information available in the medical record. For example, we could not include important variables such as smoking, an established risk factor for developing leukemia and more common among obese persons [40], since this history was not accurately recorded. In addition, we did not have data on metformin use among patients with obesity; metformin, a biguanide molecule commonly used in diabetes management, has been shown to have activity against AML in vitro , possibly by activating the LKB1/AMPK tumor suppressor pathway [41, 42].…”

Section: Discussionmentioning

confidence: 99%

Association between baseline body mass index and overall survival among patients over age 60 with acute myeloid leukemia

et al. 2013

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Acute Myeloid Leukemia (AML) is more common and more lethal among patients over the age of 60. Increased body mass index (BMI) has been associated with a higher incidence of various malignancies, including AML. We sought to determine whether patient BMI at the time of AML diagnosis is related to overall survival among elderly patients. We identified 97 patients with AML diagnosed after the age of 60 and treated with cytarabine-based induction chemotherapy. The median age was 68 years (range 60-87); 52% of patients were male, and our study population was predominantly white (89% of patients). The median overall survival (OS) for all patients was 316 days (95% CI 246-459). The hazard ratio for mortality was increased among patients with a BMI < 25 compared to BMI ≥ 30 (HR 2.14, P=0.009, 95% CI 1.21-3.77), as well as with older age (HR 1.76, P=0.015, 95% CI 1.12-2.79) and with secondary versus de novo disease (HR 1.95, P=0.006, 95% CI 1.21-3.14). After multivariable analysis, we did not find a significant association between OS and other potential confounders such as coronary artery disease or diabetes among these patients. We conclude that increased BMI was independently associated with improved OS among older AML patients at our institution.

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“…In eight studies of the relation of obesity to chronic myelogenous leukemia, a significant association was found in six [11, 14, 16–18, 26], but not in two others [6, 15]. A case–control study ( n = 253 cases and n = 270 controls), conducted at the University of Texas M. D. Anderson Cancer Center investigated the role of BMI and weight gain during adulthood in the risk for chronic myelogenous leukemia, using multivariate logistic regression for analysis [26].…”

Section: Studies Of the Relationship Between Overweight And Obesity Amentioning

confidence: 99%

Obesity and the Risk for a Hematological Malignancy: Leukemia, Lymphoma, or Myeloma

2010

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Tobacco Use, Body Mass Index, and the Risk of Leukemia and Multiple Myeloma: A Nationwide Cohort Study in Sweden

Cited by 69 publications

References 28 publications

A Pooled Analysis of Cigarette Smoking and Risk of Multiple Myeloma from the International Multiple Myeloma Consortium

A Pooled Analysis of Cigarette Smoking and Risk of Multiple Myeloma from the International Multiple Myeloma Consortium

Association between baseline body mass index and overall survival among patients over age 60 with acute myeloid leukemia

Obesity and the Risk for a Hematological Malignancy: Leukemia, Lymphoma, or Myeloma

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