title: Family history of hematologic malignancies and risk of multiple myeloma: differences by race and clinical features.
abstract: OBJECTIVE
  Multiple myeloma (MM) is the most common hematologic malignancy affecting Blacks in the USA, with standardized incidence rates that are twofold to threefold higher than Whites. The rationale for the disparity is unclear.
  
  
  METHODS
  Using participants enrolled in the Molecular And Genetic Epidemiology study of myeloma (259 MM cases; 461 controls), we examined the risk of MM associated with family history of cancer, differences by race and among cases, defining clinical features. Risk estimates were calculated using odds ratios and corresponding 95% confidence intervals from logistic regression adjusted for confounders.
  
  
  RESULTS
  Overall, MM risk in cases with relatives affected with any hematologic malignancy was significantly elevated compared to controls (OR 1.89, 95% CI 1.25-2.86). Myeloma risk associated with a family history of MM was higher than the risk associated with any hematologic malignancy (OR 3.75, 95% CI 1.75-8.05), and the effect was greater for Blacks (OR 20.9, 95% CI 2.59-168) than Whites (OR 2.04, 95% 0.83-5.04), among cases with early onset (≤60 years; OR 4.58, 95% CI 1.21-17.3) and with increasing numbers of affected relatives (p trend = 0.001). Overall, frequencies of end organ damage differed in cases with relatives affected with any hematologic malignancy and significantly more cases exhibited κ light chain restriction (OR 3.23, 95% CI 1.13-9.26).
  
  
  CONCLUSIONS
  The excess risk of MM observed in Blacks and the variation in clinical features observed in MM patients according to family history of hematologic malignancy may be attributed to a shared germline and environmental susceptibility.
authors.affiliation: Department of Pathology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294-3300, USA.
authors.forename: MaryAnn E
authors.initials: ME
authors.lastname: VanValkenburg
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Gwendolyn I
authors.initials: GI
authors.lastname: Pruitt
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Ilene K
authors.initials: IK
authors.lastname: Brill
authors.affiliation: Division of Hematology and Medical Oncology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.|UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Luciano
authors.initials: L
authors.lastname: Costa
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.|School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Maryam
authors.initials: M
authors.lastname: Ehtsham
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.|School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Ian T
authors.initials: IT
authors.lastname: Justement
authors.affiliation: Division of Hematology and Medical Oncology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.|UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Racquel D
authors.initials: RD
authors.lastname: Innis-Shelton
authors.affiliation: Division of Hematology and Medical Oncology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.|UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Salzman
authors.affiliation: Cancer Biology Program, Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, GA, USA.
authors.forename: E Shyam P
authors.initials: ES
authors.lastname: Reddy
authors.affiliation: Division of Hematology and Medical Oncology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.|UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Kelly N
authors.initials: KN
authors.lastname: Godby
authors.affiliation: Department of Genetics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Fady M
authors.initials: FM
authors.lastname: Mikhail
authors.affiliation: Department of Genetics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Carroll
authors.affiliation: Department of Pathology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294-3300, USA.|UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Vishnu B
authors.initials: VB
authors.lastname: Reddy
authors.affiliation: Department of Pathology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294-3300, USA.|UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Ralph D
authors.initials: RD
authors.lastname: Sanderson
authors.affiliation: UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.|Department of Microbiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Louis B
authors.initials: LB
authors.lastname: Justement
authors.affiliation: UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.|Division of Nephrology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.|Department of Veterans Affairs Medical Center, Birmingham, AL, USA.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Sanders
authors.affiliation: Department of Pathology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294-3300, USA. elbrown@uab.edu.|UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA. elbrown@uab.edu.|, 1824 6th Avenue South, WTI 602C, Birmingham, AL, 35294-3300, USA. elbrown@uab.edu.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People; D016022:Case-Control Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D019337:Hematologic Neoplasms / Q000453:epidemiology* / Q000235:genetics; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology* / Q000235:genetics; D012306:Risk; D044465:White People; D001741:Black or African American
keywords: African American; Black; Family history; Genetic; Multiple myeloma