By S. S. Devesa (auth.), G. Iris Obrams M. D., Ph. D., Michael Potter M.D. (eds.)
On March 27, 1990, the nationwide melanoma Institute backed a workshop at the epidemiology of a number of myeloma, held on the nationwide Institutes of future health. This ebook includes articles ready by means of individuals during this paintings store. mentioned in those papers are: the descriptive and analytic epidemi ology, variations in probability elements among blacks and whites, monoclonal gammopathies and their development, and hypotheses in regards to the etiology and pathogenesis of a number of myeloma. a number of epidemiologic learn components obtained specific cognizance in this workshop, and are reviewed intimately during this quantity. there were extraordinary raises within the prevalence of a number of myeloma during the last thirty years, specifically between older members and blacks, which can no longer be completely defined by means of alterations in diagnostic services. Occupational and environmental exposures were linked to an elevated danger of a number of myeloma, together with farming exposures, occupational publicity to petroleum and rubber processing, publicity to ionizing radiation, and asso ciations with chronic virus infections. the main amazing epidemiological discovering is mirrored within the alterations in prevalence charges of a number of myeloma that are two times as excessive in blacks compared with whites. extra, for the reason that 1950 the mortality charges for a number of myeloma have quadrupled in blacks whereas doubling for whites. between hematopoietic malignancies, a number of myeloma is the single one with elevated occurrence and mortality charges between blacks. 1\vo significant chances for explaining ethnic/racial variations in suscepti bility to a number of myeloma are genetic and environmental factors.
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Additional info for Epidemiology and Biology of Multiple Myeloma
05 3ACT- T is a derived estimate of the proportion of circulating activated T-cells 25 HLA-DR+ 20 ~w (J 0 ,/,JJ 15 6 "IT if ::E ~ u. tr ,," 20-29 30-39 40-49 50-59 80-69 AGE GROUP (Years) Figure 1: Influence of race and age on HLA-DR+ cells and activated T cells (ACT-T). Solid circles = black subjects; open circles = white subjects. s. 0001 for blacks versus whites. (From Tollerud, Clark, Brown et al. a~ --' u.. 0 #. tI. 20 10 20 10 20-29 30-39 40-49 50-59 60-69 20-29 30-39 40-49 50-59 60-69 AGE GROUP (Years I AGE GROUP (Years) Figure 2: Influence of race and age on T-cell subsets in men and women.
3). The inheritance pattern has been shown to be a Mendelian co-dominant pattern, with a similar distribution of phenotypes among black populations world-wide. Affected individuals have normal numbers of CD4+ cells, and no functional differences associated with the T4 epitope heterogeneity have been reported. 46 Table 1. 0 ];! s. s. s. 01 IValues expressed as mean ± SE percentage of lymphoid cells 2p value from multiple linear regression model adjusting for the influence of age and gender. 05 3ACT- T is a derived estimate of the proportion of circulating activated T-cells 25 HLA-DR+ 20 ~w (J 0 ,/,JJ 15 6 "IT if ::E ~ u.
However, our preliminary findings concerning participation rates may help other researchers planning to investigate the etiology of multiple myeloma. Among our cases, black females had the highest interview response rates (75%), followed by white females (64%), white males (63%), and black males (58%). The low response rate among black male cases was primarily due to an exceptionally high percentage of these subjects dying prior to interview. Approximately 15% of the cases were either too ill to be interviewed or refused to participate in the study.