Data Show Potentially Higher Disease Burden Among Male NDMM Population

New research indicates that men diagnosed with multiple myeloma often present with a more advanced stage of the disease and distinct clinical characteristics compared to women. The findings, published in Cancer, stem from an analysis of data collected in the IMAGE study, and could lead to more tailored treatment approaches.

Sex-Based Differences in Multiple Myeloma

Investigators analyzed data from 850 patients diagnosed with newly detected multiple myeloma (NDMM) between 2009 and 2020. The study focused on identifying correlations between sex and various clinical features, chromosomal abnormalities, and disease progression markers. The research confirmed diagnoses using established International Multiple Myeloma Working Group criteria and SLiM-CRAB guidelines.

The analysis revealed that male patients were more likely to be diagnosed with Stage III multiple myeloma, as defined by the International Staging System (ISS) – a measure of disease severity (OR, 2.05; 95% CI, 1.22–3.46; P = .007). They also exhibited higher levels of serum monoclonal protein (OR, 1.72; 95% CI, 1.15–2.56; P = .008), a greater prevalence of k light chain disease (OR, 1.60; 95% CI, 1.11–2.30; P = .01), and more evidence of end-organ damage (OR, 1.24; 95% CI, 1.02–1.50; P = .03) compared to female patients.

Did You Know? The IMAGE study enrolled patients 21 years and older based on schedules at the UAB Multidisciplinary Myeloma Clinic.

Conversely, male patients were less likely to present with light chain-only disease (OR, 0.63; 95% CI, 0.41-0.95; P = .03) or osteopenia (OR, 0.59; 95% CI, 0.36-0.98; P = .04) than their female counterparts. Further analysis indicated that these differences were more pronounced in men over the age of 60, though younger men (60 or under) also showed a higher likelihood of k light chain disease (OR, 1.76; 95% CI, 1.02-3.05; P = .04) and Stage III disease (OR, 2.40; 95% CI, 1.08-5.34; P = .03).

The patient population studied was largely White (51.78% female, 66.45% male), with a median age of 61 and 62 years respectively. The majority of patients in both groups reported no history of smoking (66.24% vs 50.66%) or drinking (75.83% vs 46.92%), and an annual household income of under $49,999 (64.71% vs 44.19%).

Expert Insight: Identifying these sex-specific differences in disease presentation is a crucial step toward understanding the underlying biological mechanisms driving multiple myeloma, and could ultimately lead to more effective, personalized treatment strategies.

What Could Happen Next

Researchers acknowledge that the sample size limited their ability to fully define relationships between clinical features and genomic events. Larger studies could clarify the interplay between age, sex, and specific disease characteristics in NDMM. It is possible that future research will focus on identifying the “sex-specific mechanisms” driving myeloma development, as suggested by Krystle L. Ong, PhD, lead study author from the O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham (UAB). Further investigation may also explore whether these observed differences translate into variations in treatment response or overall survival rates.

Frequently Asked Questions

What is multiple myeloma?

Multiple myeloma is a cancer that forms in plasma cells, a type of white blood cell. According to the study, diagnoses were confirmed based on revised and updated International Multiple Myeloma Working Group classification for multiple myeloma and SLiM-CRAB criteria.

What are the SLiM-CRAB criteria?

The study confirmed all cases based on revised and updated International Multiple Myeloma Working Group classification for multiple myeloma and SLiM-CRAB criteria. 96.1% of patients had a diagnosis of NDMM per CRAB criteria, while 3.9% had diagnoses fulfilling SLiM criteria.

Were there any differences in comorbidities between male and female patients?

The most common comorbidities among female and male patients, respectively, included hypertension (60.66% vs 59.21%), type 2 diabetes (19.29% vs 20.61%), hyperlipidemia (18.02% vs 27.19%), and solid tumors (12.44% vs 13.16%).

Given these emerging insights into sex-based differences in multiple myeloma, what role do you think personalized medicine will play in the future of cancer treatment?