Medical Moment: First responders at higher risk of blood cancer, study says

Published: Oct. 19, 2022 at 5:33 PM EDT
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(WNDU) - Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell.

Healthy plasma cells help you fight infections by making antibodies that recognize and attack germs.

In multiple myeloma, cancerous plasma cells accumulate in the bone marrow and crowd out healthy blood cells. Rather than produce helpful antibodies, the cancer cells produce abnormal proteins that can cause complications.

This year, an estimated 34,470 adults (19,100 men and 15,370 women) in the United States will be diagnosed with multiple myeloma. Myeloma is less common than other types of blood-related cancers, such as leukemia and lymphoma. Worldwide, an estimated 176,404 people were diagnosed with multiple myeloma in 2020.

Now, researchers say first responders may be at much higher risk for developing the cancer.

21 years after the tragic events of 9/11, scientists say those first responders may be more likely to suffer from environmental exposures from carcinogens at the disaster site, putting them at risk for multiple myeloma.

“Multiple myeloma is the second most common blood cancer that happens in adults,” explained C. Ola Landgren, a doctor at Sylvester Comprehensive Cancer Center at the University of Miami.

Dr. Landgren led a team of researchers screening the blood of consenting first responders - firefighters in an initial study, then, other men and women who were on site, including police officers, and EMS personnel. The blood tests showed high rates of myeloma precursor disease, that indicates someone is at risk for developing myeloma.

“That risk was about two times higher compared to the general population,” Dr. Landgren explained.

Dr. Landren said the study findings suggests that all emergency workers who will be exposed to high levels of carcinogens need to protect their lungs and skin.

“If this is part of the job that individuals have, that they will be provided with appropriate protection devices and also that they use these devices,” Dr. Landgren finished.

There is no cure for multiple myeloma.

Some of the symptoms of multiple myeloma include pain in the back or bones, fatigue, anemia, and loss of appetite. Treatments range from chemotherapy, immunotherapy, and small molecules.

In 2021, the FDA approved idecabtagene vicleucel (Abecma®), and, in 2022, it approved ciltacabtagene autoleucel (also known as cilta-cel or Carvytki™). Both CAR T therapies target BCMA, and both approvals were for treating adults with relapsed or refractory (hard-to-treat) multiple myeloma.

Newer trials, including at MSK, are testing CAR T therapy that targets a different protein, called GPRC5D. It’s always important to have more than one antigen to target, especially if the drugs aimed at the first antigen stop working