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MULTIPLE MYELOMA, GAMMOPATHIES

Pre-diagnosis dietary patterns and risk of multiple myeloma in the NIH-AARP diet and health study

Leukemia volume 38, pages 438–441 (2024)Cite this article

Subjects

The incidence of multiple myeloma (MM), the second most common hematologic malignancy, is rising globally [1]. Therefore, research efforts focused on identifying risk factors to reduce risk of MM are essential. Several risk factors have been identified, some that are non-modifiable (older age, male sex, African American race) and others that are modifiable (obesity, dietary patterns, diabetes mellitus). Additionally, amongst 421 patients with plasma cell disorders, 82% had questions about their diet and 57% reported their questions were not addressed by their oncologists. Among those who received dietary guidance from their oncologists, 94% attempted to follow it [2].

Despite this, there is limited data on dietary patterns and MM risk with few MM cases in each study. The EPIC-Oxford cohort and Oxford Vegetarian study (65 MM cases) showed vegetarians and vegans had 77% lower relative risk to develop MM than meat eaters [Relative risk (RR) 0.23, 95% confidence interval (95% CI) 0.09–0.59] [3]. The Nurses’ Health Study and Health Professionals Follow-up Study (478 MM cases) showed the Empirical Dietary Inflammatory Pattern (EDIP) had a 16% increased MM risk in men [Hazard Ratio (HR) 1.16, 95% CI 0.96–1.24] [4]. EDIP is an empirically derived dietary pattern that assesses diet quality based on its inflammatory potential and comprises of eighteen food groups, nine proinflammatory (processed and red meat, refined grains, high-energy beverages, etc.) and nine anti-inflammatory (coffee, wine, leafy green vegetables, etc.) [5]. Therefore, we evaluated the association between pre-diagnosis dietary patterns and MM risk in the NIH-AARP Diet and Health Study, a large population-based, prospective cohort study. To our knowledge, this is also the largest epidemiologic study on diet and MM risk to date with 1401 MM cases.

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Data availability

The data that support the findings of this study are available from the NIH-AARP Diet and Health Study, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of the NIH-AARP Diet and Health Study team.

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Acknowledgements

The authors would like to thank the NIH AARP Diet and Health Study Team and Participants. This research was supported [in part] by the Intramural Research Program of the NIH, National Cancer Institute. Cancer incidence data from the Atlanta metropolitan area were collected by the Georgia Center for Cancer Statistics, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia. Cancer incidence data from California were collected by the California Cancer Registry, California Department of Public Health’s Cancer Surveillance and Research Branch, Sacramento, California. Cancer incidence data from the Detroit metropolitan area were collected by the Michigan Cancer Surveillance Program, Community Health Administration, Lansing, Michigan. The Florida cancer incidence data used in this report were collected by the Florida Cancer Data System (Miami, Florida) under contract with the Florida Department of Health, Tallahassee, Florida. The views expressed herein are solely those of the authors and do not necessarily reflect those of the FCDC or FDOH. Cancer incidence data from Louisiana were collected by the Louisiana Tumor Registry, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana. Cancer incidence data from New Jersey were collected by the New Jersey State Cancer Registry, The Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey. Cancer incidence data from North Carolina were collected by the North Carolina Central Cancer Registry, Raleigh, North Carolina. Cancer incidence data from Pennsylvania were supplied by the Division of Health Statistics and Research, Pennsylvania Department of Health, Harrisburg, Pennsylvania. The Pennsylvania Department of Health specifically disclaims responsibility for any analyses, interpretations or conclusions. Cancer incidence data from Arizona were collected by the Arizona Cancer Registry, Division of Public Health Services, Arizona Department of Health Services, Phoenix, Arizona. Cancer incidence data from Texas were collected by the Texas Cancer Registry, Cancer Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas. Cancer incidence data from Nevada were collected by the Nevada Central Cancer Registry, Division of Public and Behavioral Health, State of Nevada Department of Health and Human Services, Carson City, Nevada. We are indebted to the participants in the NIH-AARP Diet and Health Study for their outstanding cooperation. We wish to acknowledge Dr. Arthur Schatzkin who was instrumental in conceiving and establishing the NIH-AARP Diet and Health Study. We also thank former and current study leaders at the National Cancer Institute and AARP, including Louise A. Brinton, Laurence S. Freedman, Albert R. Hollenbeck, Victor Kipnis, Michael F. Leitzmann, Linda M. Liao, Charles E. Matthews, Yikyung Park, Rashmi Sinha, Amy F. Subar and Mary H. Ward. Additionally, we are thankful to Sigurd Hermansen and Kerry Grace Morrissey from Westat for study outcomes ascertainment and management and Leslie Carroll and her team at Information Management Services for data support and analysis.

Funding

This study was funded by the Center for Hematologic Malignancies at MSK and in part through the NIH/NCI Cancer Center Support Grant P30 CA008748. UAS has received the American Society of Hematology Scholar Award, the NCI MSK Paul Calabresi K12 Career Development Award for Clinical Oncology K12CA184746, the MSK Parker Institute of Cancer Immunotherapy CDA and the International Myeloma Society CDA as well as additional funding support from HealthTree Foundation, the Allen Foundation Inc, the Paula and Rodger Riney Foundation, the Willow Foundation and the David Drelich, MD, CFP, Irrevocable Trust. UAS also received non-financial support from American Society of Hematology Clinical Research Training Institute and TREC Training Workshop R25CA203650 (PI: Melinda Irwin). AML received research support from NCI 1R01CA249981–01, Sawiris Family Fund, and Paula and Rodger Riney Foundation.

Author information

Author notes

  1. These authors contributed equally: Francesca Castro, Richa Parikh.

Authors and Affiliations

  1. Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Francesca Castro, Alexander M. Lesokhin, Saad Z. Usmani & Urvi A. Shah

  2. Department of Hematology/Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA

    Richa Parikh

  3. Jacobs School of Medicine and Biomedical Science, University at Buffalo, Buffalo, NY, USA

    Jelyn C. Eustaquio

  4. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Andriy Derkach

  5. Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

    Janine M. Joseph

  6. Department of Medicine, Weill Cornell Medical College, New York, NY, USA

    Alexander M. Lesokhin, Saad Z. Usmani & Urvi A. Shah

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  1. Francesca Castro
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Contributions

Concept and design: RP, FC, AD, UAS. Acquiring data: RP, FC, AD, UAS. Analyzing data: RP, FC, AD, JE, JMJ, UAS. Drafting the manuscript: RP, FC, JE, UAS. Critical revision of the manuscript: FC, RP, JMJ, AML, SZU, UAS. Approving the final version of the paper: FC, RP, JE, AD, JMJ, AML, SZU and UAS. Submission: RP and UAS. RP and FC contributed equally to this work. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Urvi A. Shah.

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Competing interests

UAS reports research funding support from Celgene/BMS, Janssen, Plantable, Sabinsa pharmaceuticals, VeggieDoctor and M and M labs to the institution, non-financial research support; personal fees from ACCC, MashUp MD, Janssen Biotech, Sanofi, BMS, MJH LifeSciences, Intellisphere, Phillips Gilmore Oncology Communications, i3 Health and RedMedEd outside the submitted work. AML reports grants from Bristol Myers Squibb and Genentech; grants, personal fees, and non-financial support from Pfizer; and grants and personal fees from Janssen outside the submitted work. AML has a patent for US20150037346A1 licensed and with royalties paid from Serametrix, Inc. SZU reports grants/personal fees from Amgen, Celgene, Sanofi, Seattle Genetics, Janssen, Takeda, SkylineDx, Netherlands; Merck, and GSK; grant funding from Bristol Myers Squibb and Pharmacyclics; and personal fees from AbbVie, MundiPharma, Gilead, Genentech, and Oncopeptides. No disclosures were reported by the other authors.

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Castro, F., Parikh, R., Eustaquio, J.C. et al. Pre-diagnosis dietary patterns and risk of multiple myeloma in the NIH-AARP diet and health study. Leukemia 38, 438–441 (2024). https://doi.org/10.1038/s41375-023-02132-3

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