A recent paper in the Blood Cancer Journal discusses the contribution of Body Mass Index (BMI) (beyond other established clinical factors) and the risk of progression from MGUS to full blown multiple myeloma.
The study was conducted by a team from Mayo Clinic, Rochester, MN, one of the very leading centers for the treatment of blood/bone marrow cancers. It is typically mentioned that the risk of progression from MGUS to other plasma cell/lymphoid increases at the rate of 1% per year after diagnosis.
This study identified 594 MGUS patients in Olmsted County, MN diagnosed between 1995 to 2003 and followed their treatment outcomes over a prolonged period (median of 10.5 years) to either death or progression to myeloma or other blood/bone marrow disorders.
Several factors, either on their own as well as in combination with each other, impact the risk of MGUS progression:
Specifically with respect to BMI the researchers reported the following:
BMI > or = to 25 is more prevalent to result into progression from MGUS to multiple myeloma.
For the total patient pool followed in the study, the risk of progression from MGUS is very consistent with the ‘rule of thumb’ of 1 % per year, mentioned above. [3% at 5 years, 10% at 10 years, 14% at 15 years, and 17% at 20 years].
The risk of progression, however, is very different when taking BMI into account.
|Years of Follow-Up||BMI < 25||BMI > 25|
The association of BMI with progression were stronger among females than males. In other words, the risk of progression from MGUS to multiple myeloma is approximately half for those with a BMI below 25.
“There was a non-significant decreased risk among those who had decreased BMI over time, but these analyses and their interpretation were limited by power.” [not enough patients to definitively make this statement].
In other words, losing weight (and lowering BMI) during the treatment period seems to not impact the adverse effect of high BMI at the start of treatment on risk of progression. That statement, however, may change when larger groups of patients will be followed in future studies.
about the author
I am a patient diagnosed in 2014 with primary plasma cell leukemia (pPCL), a rare and aggressive variant of multiple myeloma and have been very fortunate to find treatment at the division of Cellular Therapy at the Duke University Cancer Institute. My wife, Vicki, and I have two adult children and a grandson who is the ‘light of my life’. Successful treatment has allowed Vicki and I to do what we love best : traveling the world, albeit it with some extra precautions to keep infections away. My career in the pharmaceutical industry has given me insights that I am currently putting to use as an advocate to lower drug pricing, especially prices for anti-cancer drugs and, very specifically, CAR-T therapies, with recent contributions posted by Health affairs, the Institute for Clinical and Economic Review and the Centers for Medicare and Medicaid Services.
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