Overweight/Obesity and Monoclonal Gammopathy of Undetermined Significance

Georgakopoulou, Rebecca; Andrikopoulou, Αngeliki; Sergentanis, Theodoros N.; Fiste, Oraianthi; Zagouri, Flora; Gavriatopoulou, Maria; Ψαλτοπούλου, Θεοδώρα; Kastritis, Efstathios; Terpos, Evangelos; Dimopoulos, Meletios-Athanasios

doi:10.1016/j.clml.2021.01.008

Cited by 12 publications

(9 citation statements)

References 44 publications

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“…Several wellestablished risk factors for MG provide a strong basis for defining a population for targeted screening including, increasing age 7 , male gender 7 , black ethnicity 79 and having a first-degree relative with MG 80 . Other potential risk factors for MG such as, high BMI 81 and immune-related conditions 50 , may further contribute to delineating a high-prevalence group suitable for screening.…”

Section: Who If Anyone Should We Screen For Monoclonal Gammopathy?mentioning

confidence: 99%

Monoclonal gammopathy of increasing significance: time to screen?

et al. 2022

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Monoclonal gammopathy (MG) is a frequently detected clonal B-cell or plasma cell disorder. Importantly, every multiple myeloma (MM) case is preceded by MG. Although clinical algorithms now allow earlier treatment of patients with biomarkers of malignancy before MM-induced tissue damage (CRAB) occurs, most patients are still diagnosed late. It is important to revisit how MG should be managed in clinical practice and whether screening is required. As the prevalence of MG and other medical co-morbidities both rise with increasing age, the degree of contribution of MG to disease states other than malignant progression is often unclear. This can lead to monitoring lapses and under recognition of the organ dysfunction that can occur with monoclonal gammopathy of clinical significance (MGCS). Therefore, models of progression to MM and/or MGCS require further refinement. Whilst currently MG is detected incidentally, a case for screening has been made with ongoing studies in this area. Screening has the potential benefit of earlier detection and prevention of both MGCS and delayed MM presentations, but important drawbacks include the psychosocial impact on individuals and resource burden on healthcare services. MG terminology should transition alongside our increasing understanding of the condition and genomic characterisation that have already begun to revise the MG nomenclature. The biology of MG has been poorly understood and is often inferred from the biology of MM, which is unhelpful. We review the literature and case for MG screening in this paper. In particular, we highlight areas that require focus to establish screening for MG.

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Section: Who If Anyone Should We Screen For Monoclonal Gammopathy?mentioning

confidence: 99%

Monoclonal gammopathy of increasing significance: time to screen?

et al. 2022

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“…Beyond the observed association of high BMI with progression from non-IgM MGUS to MM overall and in females, we also observed a suggestive association with progression from LC-MGUS to LC-MM in females only; however, our results for LC-MGUS/LC-MM warrant additional investigation in larger samples. A possible mechanism through which higher BMI may contribute to MGUS progression may involve adiponectin, a hormone with anti-inflammatory and insulin-sensitizing properties and known to be under-expressed in obese individuals [ 14 ]. Specifically, previous studies have reported lower levels of circulating adiponectin among MM patients compared to those with non-progressing MGUS, supporting the potential role of obesity in MGUS progression [ 15 , 16 ].…”

Section: Dear Editormentioning

confidence: 99%

Body mass index and risk of progression from monoclonal gammopathy of undetermined significance to multiple myeloma: Results from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial

et al. 2022

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“…[5][6][7] However, emerging experimental and population-based research has demonstrated a correlation between obesity and blood cancers, including leukemia, non-Hodgkin's lymphoma (NHL), and myeloma such as the progression of monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma (MM) and other lymphoproliferative diseases. 3,[8][9][10][11][12][13][14][15] Furthermore, mice fed with a high-fat diet (HFD) for 500 days show accelerated acute promyelocytic leukemia (APL) progression and disease latency independently of gender. 16 However, APL progression in lean mice is gender dependent as male mice show increased APL penetrance and shortened latency than females.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, obesity has the potential to break the gender barrier in the pathogenesis and acceleration of different blood cancers and warrants further investigation. The visceral adipose tissue (VAT) metabolic activity and a decrease in circulating adiponectin levels are critical factors for the progression of MGUS to MM in patients with obesity 13 . Furthermore, MM cells grow robustly in the presence of adipocytes derived from patients with obesity, which overexpress proliferator‐activated receptor‐γ (PPAR‐γ), cytochrome C, IL‐6, and leptin with decreased fatty acid (FA) synthase (FAS) 17 .…”

Section: Introductionmentioning

confidence: 99%

Obesity, bone marrow adiposity, and leukemia: Time to act

Kumar,

Stewart

2023

Obesity Reviews

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SummaryObesity has taken the face of a pandemic with less direct concern among the general population and scientific community. However, obesity is considered a low‐grade systemic inflammation that impacts multiple organs. Chronic inflammation is also associated with different solid and blood cancers. In addition, emerging evidence demonstrates that individuals with obesity are at higher risk of developing blood cancers and have poorer clinical outcomes than individuals in a normal weight range. The bone marrow is critical for hematopoiesis, lymphopoiesis, and myelopoiesis. Therefore, it is vital to understand the mechanisms by which obesity‐associated changes in BM adiposity impact leukemia development. BM adipocytes are critical to maintain homeostasis via different means, including immune regulation. However, obesity increases BM adiposity and creates a pro‐inflammatory environment to upregulate clonal hematopoiesis and a leukemia‐supportive environment. Obesity further alters lymphopoiesis and myelopoiesis via different mechanisms, which dysregulate myeloid and lymphoid immune cell functions mentioned in the text under different sequentially discussed sections. The altered immune cell function during obesity alters hematological malignancies and leukemia susceptibility. Therefore, obesity‐induced altered BM adiposity, immune cell generation, and function impact an individual's predisposition and severity of leukemia, which should be considered a critical factor in leukemia patients.

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Overweight/Obesity and Monoclonal Gammopathy of Undetermined Significance

Cited by 12 publications

References 44 publications

Monoclonal gammopathy of increasing significance: time to screen?

Monoclonal gammopathy of increasing significance: time to screen?

Body mass index and risk of progression from monoclonal gammopathy of undetermined significance to multiple myeloma: Results from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial

Obesity, bone marrow adiposity, and leukemia: Time to act

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