Multiple myeloma is the second most common blood cancer in the United States, and it is more common in men, with an estimated 20,030 new male cases diagnosed in 2025.  Multiple myeloma is the accumulation of clonally expanded plasma cells in the bone marrow, with risk factors such as age, race, family history of plasma cell disorder and male sex. It has been unclear why an increased risk of multiple myeloma occurs for men.

In a new study published by Wiley in Cancer, researchers from the UAB Heersink School of Medicine’s Department of Pathology examine this disparity more closely.

Dr. Krystle Ong“We analyzed data on 850 patients with newly diagnosed multiple myeloma,” said Krystle Ong, Ph.D., first author of the study and researcher in the laboratory of Elizabeth E. Brown, Ph.D., M.P.H., Endowed Professor of Cancer Pathobiology, Division of Molecular and Cellular Pathology, Associate Director for Population Science, O’Neal Comprehensive Cancer Center. “These patients were all enrolled in the Integrative Molecular and Genetic Epidemiology (IMAGE) study at UAB between 2009 and 2020.”Dr. Elizabeth Brown

Of the 850 patients in this study, 54% were male with a median age of 62. Male patients were more likely to have advanced stage of the disease at the time of diagnosis. They were also more likely to have higher serum monoclonal protein levels, an abnormal protein produced by cancerous blood cells, and a higher prevalence of organ damage including lytic bone lesions and impaired kidney function.

“Our research points to sex-specific mechanisms in the pathogenesis of multiple myeloma,” said Brown. “To our knowledge, our findings are the first to provide evidence that men present at diagnosis with greater tumor burden and that advanced age, together with male sex, is an important driver for the observed differences.”

Collaborators with Ong and Brown on this study include Kevin D. Arnold, MPH, Department of Pathology, Gayatri Ravi, M.D., UAB Department of Medicine, Meredith C. Wessel, Emory University, Faith Davies, M.D., and Gareth Morgan, M.D., Ph.D., NYU Langone Health.

“We plan to conduct future studies to fill in the gaps of our understanding of the relevant sex-specific mechanisms underlying multiple myeloma pathogenesis, said Ong. “Understanding these key factors may lead to improved risk stratification, diagnosis and clinical treatments for both men and women with early precursor conditions that lead to multiple myeloma.”