Department of Medicine, Division of Hematology, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden.
Blood. 2011 Dec 8;118(24):6284-91. doi: 10.1182/blood-2011-04-347559. Epub 2011 Oct 13.
The associations between immune-related conditions and multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS) have previously been investigated with inconsistent results. In a large population-based study, we identified 19 112 patients with MM, 5403 patients with MGUS, 96 617 matched control subjects, and 262 931 first-degree relatives. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for the association of MM and MGUS with immune-related conditions by use of logistic regression. A personal history of all infections combined was associated with a significantly increased risk of MM (OR = 1.2; 95% CI, 1.1-1.3), and a personal history of all conditions in the categories infections (OR = 1.6; 95% CI, 1.5-1.7), inflammatory conditions (OR = 1.4; 95% CI, 1.2-1.5), and autoimmune diseases (OR = 2.1; 95% CI, 1.9-2.4) was associated with a significantly increased risk of MGUS. Several specific immune-related conditions elevated the risk of MM and/or MGUS. A family history of autoimmune disease was associated with a significantly increased risk of MGUS (OR = 1.1; 95% CI, 1.00-1.2), but not MM. Our findings suggest that immune-related conditions and/or their treatment are of importance in the etiology of MGUS and possibly MM. The association of both personal and family history of autoimmune disease with MGUS indicates the potential for shared susceptibility for these conditions.
先前的研究已经探讨了免疫相关疾病与多发性骨髓瘤(MM)和意义未明的单克隆丙种球蛋白病(MGUS)之间的关联,但结果并不一致。在一项大型基于人群的研究中,我们确定了 19112 名 MM 患者、5403 名 MGUS 患者、96617 名匹配对照和 262931 名一级亲属。我们使用逻辑回归计算了 MM 和 MGUS 与免疫相关疾病之间关联的优势比(OR)和 95%置信区间(CI)。所有感染的个人病史与 MM 的风险显著增加相关(OR=1.2;95%CI,1.1-1.3),感染(OR=1.6;95%CI,1.5-1.7)、炎症性疾病(OR=1.4;95%CI,1.2-1.5)和自身免疫性疾病(OR=2.1;95%CI,1.9-2.4)的所有疾病的个人病史与 MGUS 的风险显著增加相关。一些特定的免疫相关疾病会增加 MM 和/或 MGUS 的风险。自身免疫性疾病的家族史与 MGUS 的风险显著增加相关(OR=1.1;95%CI,1.00-1.2),但与 MM 无关。我们的研究结果表明,免疫相关疾病及其治疗在 MGUS 及可能的 MM 的发病机制中具有重要意义。自身免疫性疾病的个人和家族史与 MGUS 相关表明,这些疾病可能具有共同的易感性。