All ETDs from UAB

Advisory Committee Chair

Russell Griffin

Advisory Committee Members

Elizabeth Brown

Sadeep Shrestha

Document Type


Date of Award


Degree Name by School

Master of Science (MS) School of Public Health


Multiple Myeloma (MM) is a plasma cell malignancy, which is defined in part by antibodies and complexes of immunoglobulin (Ig) heavy and light chains (IgH and IgL). Previous associations of immune-stimulating conditions such as allergic, autoimmune, and infectious conditions and the risk of multiple myeloma (MM) are inconsistent. However, these studies were conducted in populations of European ancestry, leaving the possibility that these conditions may contribute to the excess risk of plasma cell proliferative disorders observed among Black Americans. Therefore, we assessed MGUS, a precursor condition to myeloma, and MM risk related to a history of allergy, atopy, infections and autoimmune disease using data from a population-based case-control study of Blacks and Whites. Methods Data were obtained from 239 MGUS cases, 847 MM cases, and 1328 age-, race-, sex- and geographically- matched controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression adjusted for confounders. iii Results With shingles (ORMM = 1.67, CIMM: 1.31-2.12), pneumonia (ORMGUS = 1.97, CIMGUS: 1.37-2.82) any autoimmune, rheumatic, or connective tissue disease (ORMGUS = 1.48, CIMGUS: 1.07-2.04) and fibromyalgia or fibrositis (ORMGUS = 2.67, CIMGUS: 1.51-4.71) we found some inconclusive but significant increases in MGUS MM risk with a past history individual immune-stimulating conditions. In contrast, we found a consistent MM-protective effect for most allergic conditions, including animal allergies (ORMM=0.59, CIMM: 0.42-0.83) allergic skin reactions (ORMM=0.42, CIMM: 0.30-0.60), and any urgent medical treatment due to an allergy (ORMM=0.76, CIMM: 0.60-0.96). Conclusion We identified a history of allergy as a protective factor for both MGUS and MM, and that select autoimmune diseases and infections may increase the risk of MGUS and MM. For the first time, we analyzed variations in risk of MGUS and MM and measured a large variety of exposures in the setting of sociodemographic features for both Blacks and Whites in the context of clinical defining features. With our evidence, although MM development is known to be both genetic and environmental, the role environmental exposures play in the pathogenesis of MGUS and MM is further emphasized. Our findings help give further understanding of MGUS and MM risk factors.

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