Association of BMI, smoking, and alcohol with multiple myeloma mortality in Asians: A pooled analysis of more than 800,000 participants in the Asia cohort Consortium

Background: To date, few epidemiologic studies have been conducted to elucidate lifestyle-related risk factors for multiple myeloma in Asia. We investigated the association of body mass index (BMI), smoking, and alcohol intake with the risk of multiple myeloma mortality through a pooled analysis of more than 800,000 participants in the Asia Cohort Consortium. Methods: The analysis included 805,309 participants contributing 10,221,623 person-years of accumulated follow-up across Asia Cohort Consortium cohorts. HRs and 95% confidence intervals (95% CI) for the association between BMI, smoking, and alcohol at baseline and the risk of multiple myeloma mortality were assessed using a Cox proportional hazards model with shared frailty. Results: We observed a statistically significant dose-dependent association between BMI categories and the risk of multiple myeloma mortality (<18.5 kg/m²: HR ¼ 0.80, 95% CI: 0.52–1.24; 18.5–24.9 kg/m²: reference; 25.0–29.9 kg/m²: HR ¼ 1.17, 95% CI: 0.94–1.47; ≥30 kg/m²: HR ¼ 1.61, 95% CI: 0.99–2.64, P_trend ¼ 0.014). By sex, this association was more apparent in women than in men (P for heterogeneity between sexes ¼ 0.150). We observed no significant associations between smoking or alcohol consumption and risk of multiple myeloma mortality. Conclusions: This study showed that excess body mass is associated with an increased risk of multiple myeloma mortality among Asian populations. In contrast, our results do not support an association between smoking or alcohol consumption and the risk of multiple myeloma mortality in Asian populations. Impact: This study provides important evidence on the association of BMI, smoking, and alcohol with the risk of multiple myeloma mortality in Asian populations.