An elevated risk of myeloma precursor disease, monoclonal gammopathy of undetermined significance (MGUS), was identified among Fire Department of the City of New York (FDNY) World Trade Center (WTC)-exposed firefighters. Further investigation was needed to determine if these findings were reproducible in a more heterogeneous WTC-exposed rescue/recovery workers cohort, the Stony Brook University-General Responder Cohort GRC (SBU-GRC). MGUS risk was compared between the cohorts and to published general population estimates from Olmsted County, MN, USA. In this observational seroprevalence study, odds ratios (OR) and age-standardized risk ratios (RR) of MGUS (M-spike and light-chain-MGUS combined), M-spike, and light-chain-MGUS were estimated using logistic regression. Age-standardized prevalences were calculated for white males aged 50–79; RRs were estimated by comparing risk in the WTC-exposed cohort with the Olmsted County screened cohort. SBU-GRC had elevated odds of MGUS compared with FDNY (OR = 1.38; 95%CI = 1.00–1.89). The age-standardized prevalence of MGUS was 9.0/100 persons (95%CI = 7.5–10.6), over two-fold higher than the general population (RR = 2.08; 95%CI = 1.72–2.51); the age-standardized prevalence of light-chain-MGUS was 3.5-fold higher (RR = 3.54; 95%CI = 2.52–4.97). This study adds to mounting evidence supporting an association between WTC/environmental exposures and MGUS among rescue/recovery workers. Access to MGUS screenings for the entire WTC-exposed cohort could allow for treatment interventions that improve survival.
纽约市消防局（FDNY）曾接触世界贸易中心（WTC）事件的消防员中被发现存在骨髓瘤前驱疾病——意义未明的单克隆丙种球蛋白病（MGUS）的风险升高。需要进一步研究以确认这些发现在更具异质性的WTC暴露救援/恢复工作人员队列（石溪大学通用响应者队列GRC，SBU-GRC）中是否可复现。本研究比较了不同队列间MGUS风险，并与美国明尼苏达州奥姆斯特德县已公布的普通人群估计值进行了对比。在这项观察性血清阳性率研究中，采用逻辑回归估计了MGUS（M蛋白与轻链型MGUS合并）、M蛋白型及轻链型MGUS的比值比（OR）和年龄标准化风险比（RR）。研究计算了50-79岁白人男性的年龄标准化患病率；通过比较WTC暴露队列与奥姆斯特德县筛查队列的风险来估计RR。与FDNY队列相比，SBU-GRC队列的MGUS发生比值更高（OR=1.38；95%CI=1.00–1.89）。MGUS的年龄标准化患病率为9.0/100人（95%CI=7.5–10.6），是普通人群的两倍以上（RR=2.08；95%CI=1.72–2.51）；轻链型MGUS的年龄标准化患病率高出3.5倍（RR=3.54；95%CI=2.52–4.97）。本研究为支持WTC/环境暴露与救援/恢复工作人员MGUS之间的关联提供了更多证据。为全部WTC暴露队列提供MGUS筛查可能有助于通过治疗干预改善生存率。
肿瘤(癌症)患者之家