Study highlights obesity’s role in blood condition leading to multiple myeloma blood cancer

The possible interplay between lifestyle factors such as smoking, insufficient sleep, and obesity, and their influence on a blood condition that can lead to a specific type of blood cancer, warrants further investigation, according to experts.

Recent findings published in “Blood Advances” suggest that certain modifiable risk factors, notably smoking and obesity, might elevate the risk of developing monoclonal gammopathy of undetermined significance (MGUS). This condition often precedes multiple myeloma, a form of blood cancer.

Dr. David Lee, an internal medicine resident at Massachusetts General Hospital and co-author of the study, emphasised the urgency of this research. He noted that despite significant advancements in multiple myeloma treatments, it remains incurable and is often diagnosed after considerable damage to the patient’s organs. He added, “Our research group is focused on investigating risk factors and aetiology of MGUS to better understand who may be at increased risk for developing MGUS and its progression to multiple myeloma.”

MGUS is characterised by abnormally high levels of a protein called M protein in the blood. While in most instances MGUS does not cause problems, there is an annual 1% risk of progression from MGUS to myeloma, a cancer affecting plasma cells.

Myeloma results in an accumulation of a type of white blood cell in the bone marrow, leading to tumour formation throughout the bones. The most significant risk factor for developing myeloma is age, particularly affecting those over 45. The disease is more prevalent in men and is twice as likely to occur in black individuals compared to white individuals. Furthermore, having overweight or obesity has been identified as a risk factor for myeloma.

Dr. Brian Durie, Chief Scientific Officer of the International Myeloma Foundation and a haematologist and oncologist at Cedars-Sinai Medical Center, who was not part of the study, highlighted a known correlation between MGUS, myeloma, and obesity. He explained, “There’s also a correlation between obesity and a lot of other things, other kinds of cancer, other kinds of issues with your immune system.”

The study indicated that obesity might be associated with a 73% higher likelihood of having MGUS compared to those without obesity. However, the researchers cautioned that while there is a notable connection, it does not definitively prove causation.

Dr. Gary Schiller, a clinical investigator in multiple myeloma and hematologic malignancies at the University of California Los Angeles, also not involved in the study, suggested alternative explanations for the presence of MGUS. He explained that MGUS is relatively common, especially in older populations, and its occurrence might coincide with other factors like increased body mass index and reduced sleep quality. Schiller cautioned against hastily interpreting these associations as causal relationships.

Schiller and others have investigated the influence of obesity on the progression of MGUS, exploring theories involving hormones with anti-inflammatory properties that might be deficient in individuals who have overweight. However, he asserts that the current evidence does not firmly support these hypotheses.

The authors of the study believe their findings could be instrumental in guiding future research into the role of modifiable risk factors in cancer risk. Lee stressed the importance of understanding the relationship between MGUS and these risk factors to develop effective preventative health strategies against diseases like multiple myeloma.

Durie pointed out the current lack of sufficient data to confirm that lifestyle modifications in response to these risk factors would significantly impact MGUS or myeloma outcomes. Nonetheless, he mentioned animal studies that suggest this area is worth future exploration.

The potential of modifiable risk factors in influencing health outcomes is significant, according to Durie. He suggested that efforts to reduce obesity could potentially improve outcomes for patients, emphasising the personal relevance and potential impact of such changes.

Both Durie and Schiller advise individuals with obesity and other risk factors not to be overly concerned about developing MGUS or myeloma. Durie noted, “The vast majority of patients with MGUS will never develop myeloma.” He stressed that for many, the risk of progression is low, and they are more likely to succumb to unrelated causes.

Schiller echoed these sentiments, highlighting the immediate and more pressing health risks associated with obesity, such as hypertension, diabetes, and cardiovascular diseases. He argued that these more immediate health concerns should take precedence over the potential risk of MGUS in the context of obesity.