Increasing body mass index (BMI) allows growth and progression of disease in patients with multiple myeloma, a study published in Cancer Letters has shown.1

The literature shows little attention has been given to the impact of increasing patient weight on cancer growth, with even fewer studies including morbidly obese patients. Therefore, Katie DeCicco-Skinner, PhD, associate professor of biology at American University, Washington, DC, and colleagues sought to determine the effects of BMI on multiple myeloma.

As a cancer patient’s weight increases to a higher weight category, their BMI contributes to multiple myeloma growth and progression, explained DeCicco-Skinner. Risk of cancer-related death increases by 10% for each 5 kg/m2 increase in BMI.

For this study, BMI ranges are defined as: normal, 20-25 kg/m2; overweight, 25-30 kg/m2; obese, 30-35 kg/m2; and super obese, 35-40 kg/m2.

Stem cells were obtained from the discarded fat of patients who underwent elective liposuction. Fat cells are important to the proliferation, survival, progression, and drug resistance of cancer cells in bone marrow. The stem cells were developed into fat cells, then cultured with multiple myeloma

Study findings demonstrate that fat cells communicate with multiple myeloma cells. As the fat cells increase in size, they gain additional lipid and secrete a high amount of inflammatory proteins that contribute to cancer progression. Higher BMI was also correlated to increased angiogenesis and cell adhesion, both of which are key indicators of malignant progression.

Based on these findings, the researchers suggest clinicians consider tailoring multiple myeloma treatment based on the patient’s BMI. “A patient may need to receive drugs to block inflammatory or other obesity-specific proteins, in addition to standard anticancer drugs they receive,” concluded DeCicco-Skinner.

Reference

1. Bullwinkle EM, Parker MD, Bonan NF, Bonan NF, Falkenberg LG, Davison SP, DeCicco-Skinner KL. Adipocytes contribute to the growth and progression of multiple myeloma: unraveling obesity related differences in adipocyte signaling. Cancer Lett. 2016;380(1):114-121.