Fine Particulate Matter and Myeloma Outcomes in Urban Cohort | Michael Wysota, MD | ASH 2023

Yeah, I'm Dr. Michael Isoda. I'm a third year oncology fellow at Montefiore Medical Center in the Bronx, New York. And I'll be presenting an abstract that this year is ASH that talks about how exposure to fine particulate matter, an element of pollution, outdoor air pollution that may contribute to worse outcomes in a cohort of multiple myeloma patients. So fine particulate matter are small particles that are part of outdoor air pollution that typically come from fossil fuel burning and biomass burning. And they're considered particularly dangerous components of outdoor air pollution, particularly because of their small size. They can penetrate the lung tissue pretty far and get deep into the tissue and cause cancer by causing various mutations. And it's previously been studied that people exposed to these high rates of particulate matter do have higher rates of mutation and increased risk of various malignancies. Our county in the Bronx is a very poor and underserved county of about 1.4 million people. The health outcomes in the Bronx are very poor, but we have a high burden of cancer. And historically speaking, we have high rates of outdoor air pollution exposure in our patients. So basically what we were able to do was generate a model of outdoor air pollution and overlay patient addresses to this model and to see how air pollution contributes to survival in multiple myeloma patients. We had a cohort of about 1,600 patients that were presented to Montefiore Medical Center for myeloma over the course of the last about 25 years. Our patients were exposed to levels of fine particulate matter higher than the EPA safe standard of 12 parts per million, typically on average of eight or nine years throughout the time that we assessed. So they were exposed to higher rates of outdoor air pollution. And what we found was that in patients with multiple myeloma, exposure to higher rates of outdoor air pollution correlated with worse overall survival in our patients. In fact, we found that for every year that patients were exposed to this higher level of pollution, the survival decreased by about 7%. So this is a very interesting finding for our population. And this definitely highlights the need for additional population level studies to examine how outdoor air pollution affects outcomes, not just in myeloma, but in a variety of different cancers. And in the future, we also are planning to look at how the pollution affects certain myeloma specific parameters as well as outcomes. So pollution exposure doesn't tell the entire story because myeloma outcomes, especially now are affected by a variety of treatment related and patient related factors. But it's certainly a very interesting piece and possibly a significant component to the overall health of our patients with cancer and may influence how we approach public policy for our patients with cancer going forward.