New Research Explains Sex-Based Differences in Multiple Myeloma and Treatment Considerations

New study findings published in Cancer offer insight into the reasons why multiple myeloma (MM) affects men at nearly twice the rate of women.

Why Does MM Affect Men More Than Women?

In the study, researchers analyzed data from 850 patients with newly diagnosed MM enrolled in the IMAGE study at the University of Alabama at Birmingham and compared clinical presentations between males and females at diagnosis.^1,2 The goal was to better understand sex-based differences in MM incidence by examining a broad range of clinical and epidemiological factors among a diverse patient population.^1,2

Fifty-four percent of patients in the study were male and 40% self-identified as Black, reflecting patient populations that are known to be at increased risk for MM. The median age at diagnosis was 62 years, and the median body mass index (BMI) was 29.1. Male patients reported higher rates of smoking and alcohol use, greater annual income, and more hyperlipidemia than female patients; however, the study authors noted that these trends are consistent in the general US population.^1,2

Compared with females, male patients with newly diagnosed MM were more likely to present with advanced disease, including International Staging System stage 3, which is the most advanced stage, characterized by a high level of beta-2 microglobulin in the blood.^1,2

Men with MM were more likely than women to present with higher disease burden, including elevated serum monoclonal protein levels, greater organ failure, particular kidney disease, and increased bone lesions.^1,2

“This research suggests that sex-specific mechanisms promote multiple myeloma pathogenesis, which may account for the excess risk seen in men,” Krystle L. Ong, PhD, of the O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, and lead author, said in a news release.²

However, further results found that men were less likely to have low bone mineral density. Sex-based differences in myeloma-defining features continued even after adjusting for demographic and lifestyle factors, including race, age, BMI, education, income, smoking, and alcohol use.^1,2

“These findings may be used to improve risk stratification, diagnosis, and tailored treatments for both men and women with newly diagnosed multiple myeloma or related early precursor conditions,” Ong said in a news release.²

Understanding Signs and Risks of MM

MM is characterized by the buildup of clonally expanded plasma cells in the bone marrow, leading to organ damage and disease-defining events that require treatment. Early MM may be asymptomatic, but as the disease progresses, patients can develop a range of symptoms. These include bone pain in the spine, chest, or hips; fatigue; frequent infections; weight loss; weakness; gastrointestinal issues such as nausea or constipation; mental confusion; increased thirst; and frequent urination.^1,3

Known risk factors for MM include older age, Black race-associated factors, family history of plasma cell disorders, genetic susceptibility, and male sex. As standardized incidence rates are increasing twice as high in males as in females, researchers estimated 20,030 new male cases diagnosed in 2025.^1,3

How Pharmacists Can Impact MM Care

For pharmacists, these findings indicate that male patients with MM often present with more advanced disease, including greater renal and bone involvement. This emphasizes the importance of careful medication selection, renal dose adjustments, and close monitoring for individuals at higher risk. Understanding and considering sex-based differences among individuals diagnosed with MM could help treatment planning and proactive supportive care.

REFERENCES

1. Ong K, Arnold K, Wessel M, et al. Sex differences in the clinical presentation of patients with newly diagnosed multiple myeloma. Cancer. January 12, 2026. Accessed January 14, 2026. https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.70192

2. Why are men more likely to develop multiple myeloma than women? News release. EurekAlert! January 12, 2026. Accessed January 14, 2026. https://www.eurekalert.org/news-releases/1111702

3. Mayo Clinic Staff. Multiple myeloma. News release, Mayo Clinic. December 20, 2024. Accessed January 14, 2026. https://www.mayoclinic.org/diseases-conditions/multiple-myeloma/symptoms-causes/syc-20353378