Risk of multiple myeloma following medication use and medical conditions: a case-control study in Connecticut women.
BACKGROUND
Certain commonly used drugs and medical conditions characterized by chronic immune dysfunction and/or antigen stimulation have been suggested to affect important pathways in multiple myeloma tumor cell growth and survival. We conducted a population-based case-control study to investigate the role of medical history in the etiology of multiple myeloma among Connecticut women.


METHODS
A total of 179 incident multiple myeloma cases (21-84 years, diagnosed 1996-2002) and 691 population-based controls was included in this study. Information on medical conditions, medications, and medical radiation was obtained by in-person interviews. We calculated odds ratios (OR) as measures of relative risks using logistic regression models.


RESULTS
A reduced multiple myeloma risk was found among women who had used antilipid statin therapy [OR, 0.4; 95% confidence interval (95% CI), 0.2-0.8] or estrogen replacement therapy (OR, 0.6; 95% CI, 0.4-0.99) or who had a medical history of allergy (OR, 0.4; 95% CI, 0.3-0.7), scarlet fever (OR, 0.5; 95% CI, 0.2-0.9), or bursitis (OR, 0.4; 95% CI, 0.2-0.7). An increased risk of multiple myeloma was found among women who used prednisone (OR, 5.1; 95% CI, 1.8-14.4), insulin (OR, 3.1; 95% CI, 1.1-9.0), or gout medication (OR, 6.7; 95% CI, 1.2-38.0).


CONCLUSIONS
If our results are confirmed, mechanistic studies examining how prior use of insulin, prednisone, and, perhaps, gout medication might promote increased occurrence of multiple myeloma and how antilipid statins, estrogen replacement therapy, and certain medical conditions might protect against multiple myeloma may provide insights to the as yet unknown etiology of multiple myeloma.
Landgren
Ola
O
Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Boulevard, Building EPS/Room 7110, Bethesda, MD 20892-7236, USA. landgreo@mail.nih.gov
Zhang
Yawei
Y
Zahm
Sheila Hoar
SH
Inskip
Peter
P
Zheng
Tongzhang
T
Baris
Dalsu
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000150:complications; D016022:Case-Control Studies; D003237:Connecticut / Q000453:epidemiology; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects; D008487:Medical History Taking; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D011241:Prednisone / Q000009:adverse effects; D012306:Risk; D016387:Women's Health
D000893:Anti-Inflammatory Agents; D000960:Hypolipidemic Agents; D007328:Insulin; D011241:Prednisone