Multiple Myeloma and Its Precursor Disease Among Firefighters Exposed to the World Trade Center Disaster.
Multiple Myeloma and Its Precursor Disease Among Firefighters Exposed to the World Trade Center Disaster.
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DOI：
10.1001/jamaoncol.2018.0509
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发表时间：
2018-06-01
期刊：
影响因子：
28.4
通讯作者：
Prezant DJ
中科院分区：
文献类型：
--
作者：
Landgren O;Zeig-Owens R;Giricz O;Goldfarb D;Murata K;Thoren K;Ramanathan L;Hultcrantz M;Dogan A;Nwankwo G;Steidl U;Pradhan K;Hall CB;Cohen HW;Jaber N;Schwartz T;Crowley L;Crane M;Irby S;Webber MP;Verma A;Prezant DJ
世界贸易中心灾难现场的环境暴露是否与多发性骨髓瘤及其前驱疾病--意义不明的单克隆丙种球蛋白病（MGUS）--在纽约市消防员中相关？在该病例系列中，16名参与者在2001年9月11日之后被诊断为多发性骨髓瘤，发病的中位年龄为57岁，在具有相关数据的亚组中，高比例的病例患有轻链骨髓瘤，浆细胞为CD 20阳性。在筛选研究中，发现世贸中心暴露与轻链MGUS和总体MGUS在统计学上显著相关。世界贸易中心灾难暴露与骨髓瘤前驱疾病（MGUS）有关，可能是多发性骨髓瘤早期发展的风险因素。该病例系列评估了来自世贸中心灾难现场的环境暴露是否与多发性骨髓瘤及其前驱疾病（意义不明的单克隆丙种球蛋白病）相关，在纽约市消防员中。2001年9月11日的世界贸易中心（WTC）袭击事件，造成了前所未有的已知和疑似致癌物的环境暴露，这些致癌物可能会增加多发性骨髓瘤的风险。多发性骨髓瘤之前始终存在意义不明的单克隆丙种球蛋白病（MGUS）和轻链MGUS的前体状态，可在外周血中检测到。描述诊断为多发性骨髓瘤的WTC暴露消防员的特征，并进行MGUS和轻链MGUS的筛查研究。2001年9月11日至2017年7月1日期间诊断的消防员多发性骨髓瘤病例系列，以及2013年12月至2015年10月期间从纽约消防局（FDNY）消防员收集的血清样本中MGUS的血清阳性率研究。参与者包括所有WTC暴露的FDNY白色男性消防员，经医生确诊为多发性骨髓瘤（n = 16），以及年龄超过50岁且血清样本可用的WTC暴露FDNY白色男性消防员（n = 781）。WTC暴露定义为2001年9月11日至2002年7月25日期间在WTC现场进行的救援和/或恢复工作。多发性骨髓瘤病例信息，以及总体MGUS（即MGUS和轻链MGUS）、MGUS和轻链MGUS的年龄校正和年龄特异性患病率。2001年9月11日后，16名暴露于WTC的白色男性消防员被诊断为多发性骨髓瘤;诊断时的中位年龄为57岁（四分位距，50-68岁）。14例病例的血清/尿单克隆蛋白同种型/游离轻链数据可用; 7例（50%）患有轻链多发性骨髓瘤。在7例患者的亚组中，评估骨髓瘤细胞的CD 20表达; 5例（71%）为CD 20阳性。在筛选研究中，我们检测了781名WTC暴露的消防员的外周血。MGUS和轻链MGUS合并的年龄标准化患病率为7.63/100人（95%CI，5.45-9.81），比明尼苏达州奥姆斯特德县白色男性参考人群的患病率高1.8倍（相对患病率，1.76; 95%CI，1.34-2.29）。轻链MGUS的年龄标准化患病率比相同参考人群高3倍以上（相对患病率，3.13; 95%CI，1.99-4.93）。WTC灾难现场的环境暴露与骨髓瘤前驱疾病（MGUS和轻链MGUS）相关，可能是早期多发性骨髓瘤（特别是轻链亚型）发展的风险因素。
Are environmental exposures from the World Trade Center disaster site associated with multiple myeloma and its precursor disease, monoclonal gammopathy of undetermined significance (MGUS), in New York City firefighters? In this case series, 16 participants were diagnosed with multiple myeloma after September 11, 2001, with a median age of disease onset of 57 years, and in subsets with relevant data, a high proportion of the cases had light-chain myeloma, and plasma cells were CD20 positive. In the screening study, World Trade Center exposure was found to be statistically significantly associated with light-chain MGUS and overall MGUS. World Trade Center disaster exposures are associated with myeloma precursor disease (MGUS) and may be a risk factor for the development of multiple myeloma at an earlier age. This case series assesses whether environmental exposures from the World Trade Center disaster site are associated with multiple myeloma and its precursor disease, monoclonal gammopathy of undetermined significance, in New York City firefighters. The World Trade Center (WTC) attacks on September 11, 2001, created an unprecedented environmental exposure to known and suspected carcinogens suggested to increase the risk of multiple myeloma. Multiple myeloma is consistently preceded by the precursor states of monoclonal gammopathy of undetermined significance (MGUS) and light-chain MGUS, detectable in peripheral blood. To characterize WTC-exposed firefighters with a diagnosis of multiple myeloma and to conduct a screening study for MGUS and light-chain MGUS. Case series of multiple myeloma in firefighters diagnosed between September 11, 2001, and July 1, 2017, together with a seroprevalence study of MGUS in serum samples collected from Fire Department of the City of New York (FDNY) firefighters between December 2013 and October 2015. Participants included all WTC-exposed FDNY white, male firefighters with a confirmed physician diagnosis of multiple myeloma (n = 16) and WTC-exposed FDNY white male firefighters older than 50 years with available serum samples (n = 781). WTC exposure defined as rescue and/or recovery work at the WTC site between September 11, 2001, and July 25, 2002. Multiple myeloma case information, and age-adjusted and age-specific prevalence rates for overall MGUS (ie, MGUS and light-chain MGUS), MGUS, and light-chain MGUS. Sixteen WTC-exposed white male firefighters received a diagnosis of multiple myeloma after September 11, 2001; median age at diagnosis was 57 years (interquartile range, 50-68 years). Serum/urine monoclonal protein isotype/free light-chain data were available for 14 cases; 7 (50%) had light-chain multiple myeloma. In a subset of 7 patients, myeloma cells were assessed for CD20 expression; 5 (71%) were CD20 positive. In the screening study, we assayed peripheral blood from 781 WTC-exposed firefighters. The age-standardized prevalence rate of MGUS and light-chain MGUS combined was 7.63 per 100 persons (95% CI, 5.45-9.81), 1.8-fold higher than rates from the Olmsted County, Minnesota, white male reference population (relative rate, 1.76; 95% CI, 1.34-2.29). The age-standardized prevalence rate of light-chain MGUS was more than 3-fold higher than in the same reference population (relative rate, 3.13; 95% CI, 1.99-4.93). Environmental exposure to the WTC disaster site is associated with myeloma precursor disease (MGUS and light-chain MGUS) and may be a risk factor for the development of multiple myeloma at an earlier age, particularly the light-chain subtype.
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DOI：
10.1002/cyto.b.21249
发表时间：
2016-01
期刊：
Cytometry. Part B, Clinical cytometry
影响因子：
--
作者：
Stetler-Stevenson M;Paiva B;Stoolman L;Lin P;Jorgensen JL;Orfao A;Van Dongen J;Rawstron AC
通讯作者：
Rawstron AC
影响因子：
10.4
作者：
McGee JK;Chen LC;Cohen MD;Chee GR;Prophete CM;Haykal-Coates N;Wasson SJ;Conner TL;Costa DL;Gavett SH
通讯作者：
Gavett SH
影响因子：
168.9
作者：
Dispenzieri, Angela;Katzmann, Jerry A.;Kyle, Robert A.;Larson, Dirk R.;Melton, L. Joseph, III;Colby, Colin L.;Therneau, Terry M.;Clark, Raynell;Kumar, Shaji K.;Bradwell, Arthur;Fonseca, Rafael;Jelinek, D. F.;Rajkumar, S. Vincent
通讯作者：
Rajkumar, S. Vincent
DOI：
10.1097/jom.0b013e3181ad49c8
发表时间：
2009-08-01
影响因子：
3.2
作者：
Moline, Jacqueline M.;Herbert, Robin;Savitz, David A.
通讯作者：
Savitz, David A.
影响因子：
10.4
作者：
Lioy PJ;Weisel CP;Millette JR;Eisenreich S;Vallero D;Offenberg J;Buckley B;Turpin B;Zhong M;Cohen MD;Prophete C;Yang I;Stiles R;Chee G;Johnson W;Porcja R;Alimokhtari S;Hale RC;Weschler C;Chen LC
通讯作者：
Chen LC