American Journal of Epidemiology Vol. 126, No. 6: 1051-1062
Copyright © 1987 by The Johns Hopkins University School of Hygiene and Public Health
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ANTIGENIC STIMULATION AND THJ OCCURRENCE OF MULTIPLE MYELOMA
1Department of Epidemiology, University of Wash ington Seattle, WA
2Fred Hutchinson Cancer Research Center Seattle, WA
3Formerly with the Department of Epidemiology, University of Washington, now in private practice
4Department of Epidemiology, Department of Family and Community Medicine, University of Utah Medical Center Salt Lake City, UT
5Division of Epidemiology, Michigan Cancer Foundation Detroit, MI
6Atlanta Cancer Surveillance Center, Emory University Atlanta, GA
Reprint requests to Dr. Thomas Koepsell, Department of Epidemiology, SC-36, University of Washington, Seattle, WA 98195
To evaluate whether potent or prolonged stimulation of the immune system increases the risk of multiple myeloma, the authors compared 698 myeloma cases which occurred between July 1, 1977 and June 30, 1981 in four geographic areas of the United States with 1,683 demographically similar controls from the same areas. Cases and controls were interviewed about past exposures which may have involved antigenlc challenge. Although few positive associations emerged, those most consistent with the immune stimulation hypothesis were modest associations between myeloma and a history of rheumatic fever (relative risk (RR) = 1.74,95% confidence interval (Cl) = 1.09–2.77) and between myeloma and urinary tract infection (HR = 1.30, 95% Cl = 1.00–1.69, when self-respondent cases were compared with controls). Little association was found between the risk of myeloma and the number of past viral Illnesses, number of bacterial illnesses, or number of allergy desensitization injections. Myeloma risk was found to be Inversely related to the number of diseases against which a subject reported having been immunized, perhaps because of differences in socioeconomic status between cases and controls. These findings provide little support for the immune system stimulation hypothesis of myeloma etiology, but because of the limitations of Interview techniques for assessing antigen exposure, further studies using laboratory methods may be warranted.
immune system; multiple myeiorna
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