‘Mounting Evidence’ Suggests Exposure to Environmental Toxins Plays a Role in Onset of Myeloma, Says Expert

Firefighters and recovery workers exposed to the aftermath of 9/11 in New York City had a higher occurrence of MGUS, a condition which may progress to myeloma, according to recent research.

New York City firefighters and individuals who aided in recovery efforts — including construction workers — following the 9/11 attacks were found to have double the risk of a condition that is a precursor to multiple myeloma, a blood cancer, compared to individuals who were not present at or after the attacks, according to recent research.

The findings, according to the study’s senior author, highlight the role environmental exposures may play in the development of the blood cancer.

In 2018, researchers published data that demonstrated that members of the Fire Department of New York (FDNY) who were present at the 9/11 disaster site had a two-fold higher incidence of monoclonal gammopathy of undetermined significance (MGUS) compared with a group of individuals from Olmstead County, Minnesota, who were not exposed to the recovery site.

MGUS happens when a person has elevated levels of the monoclonal protein, an abnormal type of antibody, in the blood. When MGUS begins in the plasma cells, it may progress to multiple myeloma.

Recently, investigators assessed the presence of MGUS among an additional cohort of individuals who were present at the World Trade Center site immediately following the terrorist attacks. In addition to members of the FDNY, the authors included construction workers and law enforcement personnel.

These findings continued to show a more than two-fold elevated risk of MGUS among World Trade Center-exposed male rescue/recovery workers compared with the participants from Minnesota.

Moreover, an additional analysis of the most recent data identified that the recovery workers had a greater risk for MGUS than the members of the FDNY.

“For individuals who have jobs where these kinds of exposures do happen, it’s very important to make sure that they have proper protection devices and that they use them,” said study author Dr. Ola Landgren, professor and leader of the Experimental Therapeutics Program and Myeloma Service at the University of Miami Sylvester Comprehensive Cancer Center, in an interview with CURE®.

Landgren explained that individuals who have jobs similar to the FDNY, where they are exposed to toxic dust clouds of burning particles, may want to have themselves tested for MGUS via a blood test. If MGUS is present, patients should do yearly checkups with their doctors to monitor for myeloma, though many individuals with MGUS may never develop the disease, Landgren said.

As the findings currently stand, the rate of MGUS turning into myeloma among the 9/11-exposed and unexposed groups is virtually identical, “But if you’re asking for a definitive answer, I will have to set up an appointment in 20 years,” Landgren said.

What the prior research from 2018 has shown, however, is that rescue workers involved in 9/11 had an earlier age of onset for multiple myeloma compared to the general population (57 years old, versus 69 years old, respectively).

Additionally, 71% of patients with myeloma exposed to 9/11 had CD20-expressing plasma cells, which could lead to more aggressive disease and poorer outcomes, according to Landgren.

These findings not only have implications for individuals to monitor their health more closely but could also lay the groundwork for more research.

“This is a very important finding, because it provides mounting evidence that environmental exposures play a role in the onset of multiple myeloma and, specifically, exposure to the World Trade Center disaster would fall into this category,” Landgren concluded.

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