12th Congress of the European Hematology ... - Haematologica

12 th Congress of the European Hematology Association
working population of 419961 for Leicester (city and county) 8 this gives
a prevalence of 6.07×10 –4 . The number of farmers in Leicester is 4175 9
which gives a proportion of farmers with myeloma of 1.91×10 –3 . This
increase is significant with a p-value of 0.009 on the one sample proportion
test. The overall age range was 37-97 yrs (city 37-92 years, county
44-92 years) with a median age of 69.5 years (city) versus 70.5 years
(county) which is not significantly different. However the prevalence
was highly significantly different between patients from city (49/100000)
versus county (19/100000) with a p-value of 1.47×10 –14 indicating that living
in a rural environment per se does not predispose to myeloma. Conclusions.
As a central referral centre for patients from Leicester (city and
county) we can confirm for the population of Leicestershire that farmers
have a higher risk of developing myeloma, this is not related to just
living in a rural environment.
References
1. Erikson M, Karlson M: Occupational and other environmental factors
and multiple myeloma, Br J Ind Med 1992;49:95-103.
2. Khuder S A, Mutgi A B: meta-analysis of multiple myeloma and farming,
Am J Ind Med 1998;32:510-6.
3. Baris S, Silverman D T, Brown L M et.al. Occupation, pesticide exposure
and risk of multiple myeloma, Scand J Work Environ Health 2004;30:215-
22.
4. Viel J F, Richardson S T: Lymphoma, multiple myeloma and leukaemia
among French farmers in relation to pesticide exposure, Soc Sci Med
1993;37:771-7.
5. Brown L M, Burmeister L F, Everett G D et.al. Pesticide exposures and
multiple myeloma in Iowa, Canc Caus Control 1993;4:153-6.
6. Pukkala E, Notkola V Cancer incidence among Finnish farmers, Canc
Caus Control 1997;8:25-33.
7. Kristensen P, Andersen A, Irgens L M et.al. Incidence and risk factors of
cancer among men and women in Norwegian agriculture, Scand J Work
Environ Health 1996;22: 14-26
8. www.leicester.gov.uk, last accessed 27/2/07
9. www.leics.gov.uk, last accessed 27/2/07
0680
MIP-1 ALPHA AND ITS INFLUENCE ON SURVIVAL IN MYELOMA MULTIPLE PATIENTS
C.O. Olivier, 1 J.M. Hernandez-Martin, 1 R.M. Fisac-Herrero, 1
J.A. Queizan, 1 R. Cuello, 2 A. Barez, 3 A. Martin, 4 R. Garcia-Sanz, 5
J. Garcia-Frade, 6 C. Aguilera, 7 G. Martin-Nuñez, 8
T.M. Casado-Garcia, 1 J.F. San Miguel5 1 Hospital General De Segovia, SEGOVIA; 2 Hospital Clinico -Valladolid, VAL-
LADOLID; 3 Hospital Ntra.Sra.de Sonsoles, AVILA; 4 Hospital General- Zamora,
ZAMORA; 5 Hospital Clinico-Universitario, SALAMANCA; 6 Residencia
Rio-Hortega, VALLADODLID; 7 Hospital Del Bierzo, PONFERRADA-LEON;
8 Hospital Virgen del Puerto, PLASENCIA-CACERES, Spain
Background. Macrophage Inflammatory Protein-1alpha (MIP-1α) is a
member of CC chemokine family inducing osteoclastic activity in Multiple
Myeloma (MM), by a mechanism independent of the classic
OPG/sRANKL, that has shown its correlations with the bone disease
extension and bone resorption markers. Aims. It has been previously
suggested the MIP-1α prognostic value on survival. Our group communicated
a similar observation in a small group with little follow-up. This
is an update of this data with more cases and more follow-up. Material
and Methods. 104 MM (84 with serum MIP-1 α determination) patients
diagnosed in Hospitals of Castilla-Leon Community-Spain, whose
serum were collected at diagnosis and stored at -80ºC. The median follow-up
of the series was 100.4 months. The serum MIP-1 α was measured
by double-sandwich enzimoimmunoassay (EIA) (R&D System).
We have also analyzed bone resorption markers (CTX (β-crosslaps),
Crosslinks and bone formation markers (Osteocalcin (OC), bone Alkaline
Phosphatase (bAP)) and serum cytokines (IL6, TNF-α, IL-1β, srIL6,
HGF, VEGF, OPG and sRANKL) by EIA. Statistical Methods. Non-parametric
test (U de Man Whitney, Spearman correlation); Survival curves
of Kaplan-Meier were compared by long-rank, Breslow and Tarone test;
Multivariate analysis was realized by Regression Cox. Results. The survival
curves of our series were calculated at several follow-up times (2,
3, 4, 5 and 9 years). We evaluated the impact on survival of serum MIP-
1 α to separate the patients in two subgroups (lower and high) by several
cut-off points (ten percentiles). Patients with serum MIP-1 α concentrations
higher than 26.6 pg/mL (percentile 40) showed worse survival
at 4 and 5 years of follow-up (log-rank < 0.05; Breslow< 0.05; Tarone