Courtesy of Roswell Park Cancer Talk Blog 

Until recently, multiple myeloma has not been considered hereditary, although there are familial risks for developing the rare blood cancer. But an unprecedented genetic study led by Kenan Onel, MD, PhD, Chief of Clinical Genomics at Roswell Park Comprehensive Cancer Center, has definitively associated the risk of multiple myeloma in some individuals with inherited differences in their BRCA1 and BRCA2 genes. 

Myeloma is a rare blood cancer that affects plasma cells. Plasma cells are a type of white blood cell. When these cells multiply uncontrollably and become cancerous, they crowd out your healthy cells. Abnormal plasma cells are called myeloma, and when they build up in multiple locations in your bone marrow—the soft matter inside your bones where most of the body’s blood cells are made—the disease is called multiple myeloma. 

Risk factors among your family

Some cancers result from gene mutations that cause cells to grow erratically. Before Dr. Onel’s discovery, gene mutations associated with multiple myeloma were considered a predisposition to the disease among first-degree relatives, rather than an inherited genetic anomaly. “There is a four-times higher risk of being diagnosed among first-degree relatives,” explains Roswell Park’s Jens Hillengass, MD, PhD, Chief of Myeloma. Other known risk factors for developing multiple myeloma include obesity, gender (males are more commonly diagnosed than females), exposure to radiation, alcohol use, smoking tobacco, and being of African heritage or descent.  

African Americans have a higher risk

Myeloma is always preceded by an asymptomatic blood disorder called monoclonal gammopathy of undetermined significance (MGUS). MGUS is also considered a risk factor for myeloma and occurs more often in African Americans. According to current estimates, by 2034, roughly 24% of newly diagnosed multiple myeloma cases in the United States are expected to be among African Americans. This means that by 2034, nearly 1 in 4 new multiple myeloma patients will be African American. African Americans with a family history of multiple myeloma also have a higher risk of developing the cancer than their white counterparts with multiple myeloma in their family history. Studies show that the disparity extends to people of African heritage in multiple countries. 

New therapies available at Roswell Park offer hope

New treatments have increased the survival rate of multiple myeloma from 35% in 2000 to 50% in 2020. The current standard of care for multiple myeloma is treatment with a combination of three or four drugs, which may include chemotherapy, immunotherapy, proteasome inhibitors, monoclonal antibodies, steroids, and other therapies.  

Dr. Hillengass believes novel cellular therapies now available at Roswell Park are changing the outlook for people diagnosed with multiple myeloma. Cellular therapy uses living cells rather than pharmaceutical compounds to destroy cancer cells and often uses patients’ own cells as the “drug.” Dr. Hillengass says, “We are getting closer to a cure, especially with our new focus on cellular therapies.”  

March is Multiple Myeloma Awareness Month. For more resources and expert advice, visit www.roswellpark.org/lung, or call 1-800-ROSWELL (1-800-767-9355).