title: Respiratory tract infections in the pathway to multiple myeloma: a population-based study in Scandinavia.
abstract: Encounter with infectious antigens has been proposed to initiate the cascade of events associated with progression from premalignancy (monoclonal gammopathy of undetermined significance, MGUS) to multiple myeloma (MM). We conducted a population-based case-control study to evaluate risk of developing MM associated with a personal history of various respiratory tracts infections occurring >1 year prior to MM. Inpatient (1977-1997) and outpatient (1994-1997) diagnoses were obtained for all MM patients (n=4,476) diagnosed in Denmark (1977-1997) and 16,727 matched controls. A personal history of pneumonia was associated with a 1.6-fold (95%CI 1.3-2.0) increased risk of MM; the elevated risk was restricted to 1-4.99 years prior to the diagnosis of MM (OR=1.7,95%CI 1.3-2.2). Individuals with two and three or more previous episodes of pneumonia had a 1.7-fold (95%CI 1.0-3.0; p=0.05) and a 1.5-fold (95%CI 0.6-3.9) elevated MM risk, respectively. Pneumonia could be a trigger to the development of MM or a manifestation of immune disturbances in late-stage MGUS.
authors.affiliation: Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health & Human Services, Bethesda, MD 20892-7236, USA. landgreo@mail.nih.gov
authors.forename: Ola
authors.initials: O
authors.lastname: Landgren
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Rapkin
authors.forename: Lene
authors.initials: L
authors.lastname: Mellemkjaer
authors.forename: Gloria
authors.initials: G
authors.lastname: Gridley
authors.forename: Lynn R
authors.initials: LR
authors.lastname: Goldin
authors.forename: Eric A
authors.initials: EA
authors.lastname: Engels
mesh_terms: D000368:Aged; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology* / Q000209:etiology; D044382:Population Groups; D012042:Registries; D012141:Respiratory Tract Infections / Q000150:complications / Q000453:epidemiology*; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology