Kristinsson Sigurdur Y, Björkholm Magnus, Goldin Lynn R, Blimark Cecilie, Mellqvist Ulf-Henrik, Wahlin Anders, Turesson Ingemar, Landgren Ola
Department of Medicine, Division of Hematology, Karolinska University Hospital, Solna and Karolinska Institutet, Stockholm, Sweden.
Int J Cancer. 2009 Nov 1;125(9):2147-50. doi: 10.1002/ijc.24514.
There are emerging data to suggest a role for genetic factors in the pathogenesis of multiple myeloma (MM). Based on small numbers, certain solid tumors have been reported to occur more frequently among blood relatives of patients with MM. Using population-based data, we assessed risks for hematologic malignancies, monoclonal gammopathy of undetermined significance (MGUS), and solid tumors among first-degree relatives of patients with MM. We included 13,896 patients with MM and 54,365 matched controls. Also we identified first-degree relatives of patients with MM (n = 37,838) and controls (n = 151,068). Using a marginal survival model, we estimated relative risks (RRs) and 95% confidence intervals (CIs) for hematologic and solid tumors among family members of patients with MM and controls as measures of familial aggregation. Compared with relatives of controls, relatives of patients with MM had an increased risk of developing MM (RR = 2.1; 95% CI 1.6-2.9), MGUS (2.1; 1.5-3.1), acute lymphoblastic leukemia (ALL) (2.1; 1.0-4.2), any solid tumor (1.1; 1.0-1.1) and bladder cancer (1.3; 1.0-1.5). No significantly increased risk was found for other hematologic or solid malignancies. Our findings support a role for a shared susceptibility (genetic, environmental or both) that predisposes to MM, MGUS, ALL and bladder cancer.
越来越多的数据表明遗传因素在多发性骨髓瘤(MM)的发病机制中起作用。基于少量病例报告,某些实体瘤在MM患者的血亲中更频繁发生。利用基于人群的数据,我们评估了MM患者一级亲属中血液系统恶性肿瘤、意义未明的单克隆丙种球蛋白病(MGUS)和实体瘤的发病风险。我们纳入了13896例MM患者和54365例匹配对照。我们还确定了MM患者(n = 37838)和对照(n = 151068)的一级亲属。使用边际生存模型,我们估计了MM患者和对照家庭成员中血液系统和实体瘤的相对风险(RR)及95%置信区间(CI),作为家族聚集性的衡量指标。与对照的亲属相比,MM患者的亲属患MM(RR = 2.1;95%CI 1.6 - 2.9)、MGUS(2.1;1.5 - 3.1)、急性淋巴细胞白血病(ALL)(2.1;1.0 - 4.2)、任何实体瘤(1.1;1.0 - 1.1)和膀胱癌(1.3;1.0 - 1.5)的风险增加。未发现其他血液系统或实体恶性肿瘤的风险有显著增加。我们的研究结果支持存在一种共同易感性(遗传、环境或两者兼有),它易导致MM、MGUS、ALL和膀胱癌。