Background: Multiple myeloma risk increases with higher adult body mass index (BMI). Emerging evidence also supports an association of young adult BMI with multiple myeloma. We undertook a pooled analysis of eight case-control studies to further evaluate anthropometric multiple myeloma risk factors, including young adult BMI.Methods:We conducted multivariable logistic regression analysis of usual adult anthropometric measures of 2,318 multiple myeloma cases and 9,609 controls, and of young adult BMI (age 25 or 30 years) for 1,164 cases and 3,629 controls.Results:In the pooled sample, multiple myeloma risk was positively associated with usual adult BMI; risk increased 9% per 5-kg/m2increase in BMI [OR, 1.09; 95% confidence interval (CI), 1.04-1.14;P= 0.007]. We observed significant heterogeneity by study design (P= 0.04), noting the BMI-multiple myeloma association only for population-based studies (Ptrend= 0.0003). Young adult BMI was also positively associated with multiple myeloma (per 5-kg/m2; OR, 1.2; 95% CI, 1.1-1.3;P= 0.0002). Furthermore, we observed strong evidence of interaction between younger and usual adult BMI (Pinteraction<0.0001); we noted statistically significant associations with multiple myeloma for persons overweight (25-<30 kg/m2) or obese (30+ kg/m2) in both younger and usual adulthood (vs. individuals consistently <25 kg/m2), but not for those overweight or obese at only one time period.Conclusions:BMI-associated increases in multiple myeloma risk were highest for individuals who were overweight or obese throughout adulthood.Impact:These findings provide the strongest evidence to date that earlier and later adult BMI may increase multiple myeloma risk and suggest that healthy BMI maintenance throughout life may confer an added benefit of multiple myeloma prevention.Cancer Epidemiol Biomarkers Prev; 26(6); 876-85. ©2017 AACR.

Cancer Control Research BC Cancer Agency and School of Population and Public Health University of British Columbia Vancouver British Coulmbia Canada

Cancer Epidemiology Centre Cancer Council Victoria Melbourne Victoria Australia Department of Biostatistics Melbourne School of Population and Global Health The University of Melbourne Melbourne Victoria Australia

Center for Chronic Immunodeficiency Faculty of Medicine University of Freiburg Freiburg Germany

Channing Division of Network Medicine Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston Massachusetts

Department of Cancer Epidemiology and Genetics Masaryk Memorial Cancer Institute Brno Czech Republic

Department of Cancer Prevention and Control Roswell Park Cancer Institute Buffalo New York

Department of Environmental and Occupational Health Drexel University Dornsife School of Public Health Philadelphia Pennsylvania

Department of Health Studies University of Chicago Chicago Illinois

Department of Internal Medicine University of Iowa Iowa City Iowa

Department of Pathology and the Cancer Control and Population Sciences Program UAB Comprehensive Cancer Center University of Alabama at Birmingham Birmingham Alabama

Department of Pathology City of Hope Duarte California

Department of Preventive Medicine Keck School of Medicine and Norris Comprehensive Cancer Center University of Southern California Los Angeles California

Department of Public Health Occupational Health Section University of Cagliari Cagliari Italy

Department of Surgery Yale School of Medicine New Haven Connecticut Department of Environmental Health Sciences Yale School of Public Health New Haven Connecticut

Division of Cancer Epidemiology and Genetics National Cancer Institute NIH Department of Health and Human Services Rockville Maryland

Division of Hematology and Hematologic Malignancies University of Utah School of Medicine Salt Lake City Utah

German Cancer Center Division of Cancer Epidemiology Heidelberg Germany

International Agency for Research on Cancer Lyon France

Ireland School of Nursing and Human Sciences Dublin City University Glasnevin Dublin Ireland

Mount Sinai School of Medicine New York New York International Prevention Research Institute Lyon France

Program in Epidemiology Fred Hutchinson Cancer Research Center Seattle Washington Department of Epidemiology University of Washington School of Public Health Seattle Washington

Registry of Hematological malignancies of Côte d'Or University of Burgundy and University Hospital Dijon France

Unit of Infections and Cancer Cancer Epidemiology Research Programme Catalan Institute of Oncology IDIBELL Barcelona Spain

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$a Birmann, Brenda M $u Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. brenda.birmann@channing.harvard.edu.

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$a Young Adult and Usual Adult Body Mass Index and Multiple Myeloma Risk: A Pooled Analysis in the International Multiple Myeloma Consortium (IMMC) / $c BM. Birmann, G. Andreotti, AJ. De Roos, NJ. Camp, BCH. Chiu, JJ. Spinelli, N. Becker, V. Benhaim-Luzon, P. Bhatti, P. Boffetta, P. Brennan, EE. Brown, P. Cocco, L. Costas, W. Cozen, S. de Sanjosé, L. Foretová, GG. Giles, M. Maynadié, K. Moysich, A. Nieters, A. Staines, G. Tricot, D. Weisenburger, Y. Zhang, D. Baris, MP. Purdue,

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$a Background: Multiple myeloma risk increases with higher adult body mass index (BMI). Emerging evidence also supports an association of young adult BMI with multiple myeloma. We undertook a pooled analysis of eight case-control studies to further evaluate anthropometric multiple myeloma risk factors, including young adult BMI.Methods:We conducted multivariable logistic regression analysis of usual adult anthropometric measures of 2,318 multiple myeloma cases and 9,609 controls, and of young adult BMI (age 25 or 30 years) for 1,164 cases and 3,629 controls.Results:In the pooled sample, multiple myeloma risk was positively associated with usual adult BMI; risk increased 9% per 5-kg/m2increase in BMI [OR, 1.09; 95% confidence interval (CI), 1.04-1.14;P= 0.007]. We observed significant heterogeneity by study design (P= 0.04), noting the BMI-multiple myeloma association only for population-based studies (Ptrend= 0.0003). Young adult BMI was also positively associated with multiple myeloma (per 5-kg/m2; OR, 1.2; 95% CI, 1.1-1.3;P= 0.0002). Furthermore, we observed strong evidence of interaction between younger and usual adult BMI (Pinteraction<0.0001); we noted statistically significant associations with multiple myeloma for persons overweight (25-<30 kg/m2) or obese (30+ kg/m2) in both younger and usual adulthood (vs. individuals consistently <25 kg/m2), but not for those overweight or obese at only one time period.Conclusions:BMI-associated increases in multiple myeloma risk were highest for individuals who were overweight or obese throughout adulthood.Impact:These findings provide the strongest evidence to date that earlier and later adult BMI may increase multiple myeloma risk and suggest that healthy BMI maintenance throughout life may confer an added benefit of multiple myeloma prevention.Cancer Epidemiol Biomarkers Prev; 26(6); 876-85. ©2017 AACR.

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$a Andreotti, Gabriella $u Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, Maryland.

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$a De Roos, Anneclaire J $u Department of Environmental and Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania.

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$a Camp, Nicola J $u Division of Hematology and Hematologic Malignancies, University of Utah School of Medicine, Salt Lake City, Utah.

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$a Brown, Elizabeth E $u Department of Pathology and the Cancer Control and Population Sciences Program, UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama.

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$a Cocco, Pierluigi $u Department of Public Health, Occupational Health Section, University of Cagliari, Cagliari, Italy.

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$a Weisenburger, Dennis $u Department of Pathology, City of Hope, Duarte, California.

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$a Baris, Dalsu $u Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, Maryland.

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