Impact of Environmental Factors on the Risk of Multiple Myeloma, a Case-Control Study in Myanmar

Soe, Pyone Pyone [UCL] Win, Sein Hein, Moe Aung, Khin Thida Nyein, Myint Myint Robert, Annie [UCL] Coutelier, Jean-Paul [UCL]

BACKGROUND: Environmental factors, including exposure to chemicals and certain pathogens, may increase the risk of developing Multiple Myeloma (MM), as indicated by studies conducted primarily in industrialized countries. On the other hand, some epidemiological and experimental data also support the hypothesis that exposure to infections may enhance cancer immunosurveillance, particularly against multiple myeloma. AIM: To improve our understanding of the association between environmental factors and the risk of multiple myeloma, particularly in developing countries, this research was conducted to ascertain, in a South-East Asian setting, if environmental factors can modulate the risk of developing multiple myeloma. METHODOLOGY: A hospital-based case-control study was conducted using simple questionnaires in two large public hospitals in Myanmar from July to September 2020, with 40 multiple myeloma cases and a double control population seeking care in the medical and surgical Units of the same hospitals. RESULTS: Even if not significant, our results suggest an increased risk of developing multiple myeloma after exposure to chemicals used in farming, and a reduced risk for those with a history of infections such as tuberculosis, hepatitis, measles, or pneumonia. The reduction was significant for malaria at the country level. CONCLUSION: These results support the idea that certain infections can improve cancer immunosurveillance, although they still need to be confirmed in other series of patients.