Multiple Myeloma Precursor Disease in World Trade Center Firefighters
Posted: Tuesday, May 15, 2018
Firefighters who performed rescue and recovery operations at the site of the World Trade Centers in New York City on and after September 11, 2001, seem to be at increased risk for multiple myeloma precursor diseases, according to study findings published in JAMA Oncology. Lead study author Ola Landgren, MD, PhD, of the Memorial Sloan Kettering Cancer Center, explained environmental exposures at the disaster site were associated with monoclonal gammopathy of undetermined significance (MGUS) as well as light-chain MGUS and may be a risk factor for the development of multiple myeloma at an earlier age.
In a case series and screening study, the research team used data collected from the Fire Department of the City of New York World Trade Center Health Program. Participants included 16 firefighters diagnosed with multiple myeloma between September 11, 2001, and July 1, 2017, as well as 781 World Trade Center–exposed firefighters older than age 50 with available serum samples. All participants were white and male.
The median age for the 16 firefighters to be diagnosed with multiple myeloma was 57 years old—or roughly 12 years younger than the national average. In the screening study, the age-standardized prevalence rate of MGUS and light-chain MGUS combined was 7.63 per 100 persons. That rate is 1.8-fold higher than the relevant comparison population in Olmsted County, Minnesota. The prevalence rate of light-chain MGUS was more than threefold higher than the same reference population. In addition, the investigators observed, “the proportion of participants with CD20-expressing plasma cells—characteristics associated with a poorer prognosis—was more than 3.5-fold higher than found in other populations (71% vs. approximately 20%).”