Krystle Ong, Ph.D., (left) and Elizabeth Brown, Ph.D., (right). 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 in Cancer, researchers from the University of Alabama at Birmingham Marnix E. Heersink School of Medicine’s Department of Pathology examine this disparity more closely, identifying that male patients were more likely to have advanced stage of the disease at the time of diagnosis.
“Our research points to sex-specific mechanisms in the pathogenesis of multiple myeloma,” said Krystle Ong, Ph.D., first author of the study and researcher in the Division of Molecular and Cellular Pathology, and associate director for Population Science at the O’Neal Comprehensive Cancer Center at UAB. “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.”
UAB analyzed data from 850 patients with newly diagnosed multiple myeloma, where 54 percent were male with a median age of 62. These patients were all enrolled in the Integrative Molecular and Genetic Epidemiology, or IMAGE, study at UAB between 2009 and 2020. They were 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.
“We plan to conduct future studies to fill in the gaps of our understanding of the relevant sex-specific mechanisms underlying multiple myeloma pathogenesis,” Ong said. “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.”
The study took place at O’Neal Cancer Center at UAB, which is dedicated to advancing personalized care and addressing disparities in hematologic malignancies. At UAB, Brown holds the Endowed Professorship of Cancer Pathobiology.
Collaborators with Ong and Brown on this study include Kevin D. Arnold, UAB Department of Pathology; Gayatri Ravi, M.D., UAB Department of Medicine; Meredith C. Wessel, Emory University; and Faith Davies, M.D., and Gareth Morgan, M.D., Ph.D., NYU Langone Health.