Bottom Line: Memorial Sloan Kettering (MSK) researchers have done a wide-ranging study to look for the first signs of a Multiple Myeloma precursor called MGUS in various racial groups. The researchers found that MGUS appears with higher frequency in African Americans and at a much younger average age, compared with what is seen in other ethnic groups.
Multiple myeloma occurs when plasma cells, a kind of white blood cell, form tumors in the bone marrow. Every year it affects about 30,000 people in the United States; more than 100,000 people are living with multiple myeloma. The average age of onset is about 70 years; fewer than 5% of cases are diagnosed before age 50. Despite being at higher risk for developing multiple myeloma, data show that African Americans diagnosed with multiple myeloma tend to have less aggressive disease and better survival rates.
Journal: “Prevalence of myeloma precursor state monoclonal gammopathy of undetermined significance (MGUS) in 12,309 individuals 10 to 49 years old: a population-based study from the National Health and Nutritional Examination Survey” was published in the Nature publication Blood Cancer Journal on Friday, October 20, 2017.
Authors: Ola Landgren, MD, PhD, Chief of MSK’s Multiple Myeloma Service was the lead author of the new study.
Findings: The study found that prevalence rates differ substantially across ethnic groups.
Starting at age 30, African Americans already had a rate of MGUS that was close to 1%, and by ages 40 to 49, it was 3.3%. By contrast, the rate in whites over age 50 is only about 2%.
Method: To do this analysis, the investigators used data from the National Health and Nutrition Examination Survey (NHANES), a government funded-study that was set up to assess the health and nutritional status of adults and children in the United States. NHANES collected blood specimens and health data for a range of research. Dr. Landgren’s team screened 12,372 blood samples from that study: About 4,000 from African Americans, 4,000 from Hispanics, 3,600 from whites, and the rest from other ethnic groups. They included people between the ages of 10 and 50.
Author Comments: “A higher rate of MGUS translates to higher rates of multiple myeloma,” Dr. Ola Landgren, MD, Chief of the Myeloma Service at MSK explains. “And now we know the early forms of this disease may be lingering for 20 years or more in some people. It’s kind of mind-blowing.”
“It’s very possible that in the future, the standard of care will be to initiate treatment earlier in the course of the disease,” Dr. Landgren says. “This change would largely be driven by the development of drugs that have fewer side effects but are still effective, in parallel with better biomarkers to define individuals at high risk of progression.”
“These findings set the agenda for trying to identify these early cases, to learn who is going to develop cancer and determine whether we can do early intervention to prevent it.”
“As the American population becomes more diverse, it’s of major importance that everyone be included in clinical trials. Studies in a number of different cancers have suggested that cancer drugs may not work the same way across all groups.” said Dr. Landgren.