Sex differences in the clinical presentation of patients with newly diagnosed multiple myeloma

Standardized incidence rates of multiple myeloma (MM) are higher among males than females, suggesting that male sex is an important risk factor for MM, which may affect disease etiology, pathogenesis, and clinical presentation.

The association of sex with the prevalence of clinical features and chromosomal abnormalities was evaluated among 850 patients with newly diagnosed MM enrolled in the Integrative Molecular And Genetic Epidemiology (IMAGE). Risk estimates were calculated using prevalence odds ratios (OR) and corresponding 95% CIs from logistic regression adjusted for confounders.

Male patients with newly diagnosed MM by comparison with females, were more likely to have International Staging System stage III disease (odds ratio [OR] = 2.05; 95% CI, 1.22-3.46; p = .007), high serum monoclonal protein (≥3 g/dL; OR = 1.72; 95% CI, 1.15-2.56; p = .008), κ light chain disease (OR = 1.60; 95% CI, 1.11-2.30; p = .01), and more end-organ damage (OR = 1.24; 95% CI, 1.02-1.50; p = .03) including impaired renal function (OR = 1.71; 95% CI, 1.12-2.61; p = .01) and lytic lesions (OR = 1.97; 95% CI, 1.01-3.85; p = .05) and were less likely to have osteopenia (OR = 0.59; 95% CI, 0.36-0.98; p = .04) and light chain only disease (OR = 0.63; 95% CI, 0.41-0.95; p = .03) after adjusting for race, age, body mass index, education, income, smoking, and alcohol use. Significant interactions of age on the association of male sex with the prevalence of involved to uninvolved free light chain ratio ≥100 (p = .01) and any copy number abnormality (p = .04) were also observed.

These novel findings suggest that male patients with newly diagnosed MM have a greater tumor burden.