Is There a Relationship Between the Number of Myeloma Medications Used and the Risk Level of Multiple Myeloma?

Does myeloma treatment cause genetic mutations and increase genetic risk over time?

To understand whether myeloma medications damaged myeloma cells, causing an increase in genetic abnormalities and thus the genetic risk, the HealthTree Foundation developed the following study, presented at the annual meeting of the American Society of Hematology (ASH 2022), which looked at how the number of medications used to treat myeloma affected the genetic risk of patients with the disease. 

Multiple myeloma is a type of cancer that affects plasma cells in the bone marrow. It is characterized by the growth and evolution of malignant plasma cells, which can be influenced by many factors, such as the use of myeloma medications. 

The mSMART risk classification was used in the study to determine how likely it is that the disease will progress or relapse, and it is based on many factors, including whether or not the myeloma cells have certain genetic changes and how healthy the patient is overall.

About the Study

The data came from 73 people with multiple myeloma whose medical records were stored on the HealthTree Cure Hub Platform and had been thoroughly validated. The patients were diagnosed with myeloma between 2010 and 2017 and had a test called fluorescence in situ hybridization (FISH) to measure their risk of the disease within six months of their diagnosis and at different time points in the disease's evolution.

To analyze the data in this study, we looked at the same group of people over a period of time, measuring the risk level at different time points. We also used a statistical technique called “polynomial regression with Pearson's correlation coefficient,"  which allowed us to see whether there is a strong U-shaped relationship between the number of drugs taken and the risk level of multiple myeloma.

In the graph below, you can see that about 10% of the patients evolved to a higher risk level after five years. Four percent (4%) stopped being standard risk, 5% became double hit, and one patient became triple hit. This proves that the predominant genetic abnormalities can change over the course of the disease.

Graph 1. The proportion of patients in each risk level at diagnosis, and after five years

The medication count of these patients showed that, on average, patients took 10 different medications during these 5 years of treatment. 

In the figure below, you can see that the complete data analysis showed that there was no relationship between the number of medications a patient took and the evolution of their risk classification. This means that the number of medications a patient takes to treat myeloma does not seem to affect the genetic risk of their disease.

Key Takeaway

Overall, the results of this study suggest that patients with multiple myeloma should not be concerned about their genetic risk classification increasing due to the number of medications they take. This shouldn't be a factor when patients and their doctors are trying to find a good treatment plan that will help keep the disease under control in the long run.

References

Hydren, Jay R., Jorge Arturo Hurtado Hurtado Martinez, Ana Sahagun, Christian S. Cheung, Eduardo Franco Hernandez, Patricia Alejandra Flores Pérez, Felipe Flores Quiroz et al. "The Relationship between Therapeutic Pressure and Multiple Myeloma Risk Stratification: A 5 Year Real-World-Data Analysis." Blood 140, no. Supplement 1 (2022): 12583-12584.