Elevated BMI Linked to Multiple Myeloma Development and Progression

A study has uncovered that elevated body mass index (BMI), a measurement of obesity, increases an individual’s risk of developing multiple myeloma and the disease’s risk of progression.

The study, “Adipocytes contribute to the growth and progression of multiple myeloma: Unraveling obesity related differences in adipocyte signaling,” was recently published in Cancer Letters.

Multiple myeloma (MM) is a blood cancer that results from the increased production of diseased plasma cells, called myeloma cells, in the bone marrow. Established risk factors of MM are known and include age, race, and family history. Environmental factors, such as obesity, are also now being seen to drive MM development and progression.

The prevalence of obesity has doubled in the last 35 years and is a growing healthcare concern worldwide. Moreover, researchers have established that increased obesity correlates with a higher incidence of MM development and mortality. However, the molecular and biological underpinnings of this association remain unclear.

In a news release, Katie DeCicco-Skinner, an associate professor of Biology at American University and the study’s lead author, said, “Obesity increasingly plays a role in cancer cases as the numbers of those who are obese rise. Improving our understanding of how fat cells and cancer cells communicate with each other, and how the communication changes during obesity, is critical.”

DeCicco-Skinner and colleagues examined the ability of fat-derived stem cells, collected from normal, overweight, obese, and morbidly obese patients undergoing elective liposuction, to promote the growth of MM cells and progression of disease outcomes, such as adhesion and angiogenesis.

The researchers found that when MM cells were grown in the presence of fat cells collected from overweight, obese and morbidly obese individuals, as compared to growth in the presence of fat cells from normal individuals, MM disease progression indicators and cell viability significantly increased. Specifically, fat cells from overweight and obese individuals resulted in the increased growth rate, tumor-promoting signaling, and production of inflammatory factors. They also found BMI-dependent alterations in lipid levels of MM cells. Moreover, BMI positively correlated to adhesion and angiogenesis of MM cells.

“We know multiple myeloma cells will anchor into bone marrow, and fat cells in the bone marrow will support the growth and spread of the cancer. In our study, as BMI increased, we started seeing an increase in the ability of multiple myeloma cells to adhere, which causes the cancer to better anchor,” DeCicco-Skinner said. “With angiogenesis, cancer cells cannot exist without their own blood supply. We also found the amount of blood vessels that developed was directly proportional to a patient’s BMI.”

These results provide doctors with more information regarding how to appropriately establish treatment regimens for MM patients that are overweight or obese, as determined by their BMI.

“Most people think if you develop multiple myeloma, you go to the doctor, find out what the most effective drug cocktail is and how it will affect you,” DeCicco-Skinner said. “A patient may need to receive drugs to block inflammatory or other obesity-specific proteins, in addition to standard anti-cancer drugs they receive.”