Asbestos-associated neoplasms of B cell lineage

Our plain-English summary of Asbestos-associated neoplasms of B cell lineage, by E. Kagan, R.J. Jacobson, K.Y. Yeung, et al (The American Journal of Medicine, 1979).

The study

• Authors: E. Kagan, R.J. Jacobson, K.Y. Yeung, D.J. Haidak, G.H. Nachnani
• Journal: The American Journal of Medicine
• Published: 1979;67(2):325-30
• Type of article: Case report
• Cited by: 55 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Three different neoplasms of B cell lineage, chronic lymphocytic leukemia, immunoglobulin A (IgA) myeloma and immunoglobulin G (IgG) myeloma were detected in three patients who had heavy occupational exposure to asbestos dust. Two of the patients had coexistent pulmonary asbestosis, whereas the third patient had a pleural mesothelioma subsequent to his initial presentation with myeloma. Defective cell-mediated immunity and hyperactivity of B cell function have previously been noted in patients with asbestosis. We suggest the possibility that these asbestos-related immunologic derangements may predispose to the development of immunoproliferative and lymphoproliferative neoplasms, since such tumors have been observed in a variety of other settings, characterized by protracted hyperactivity of the immune system.

In plain English

This article was mainly a report of three individual patients. The authors described three men with heavy job-related asbestos exposure who developed cancers of B cell lineage. A 54-year-old South African man who had worked about three years underground in an amosite mine had IgA myeloma, and his chest X-ray was consistent with asbestos-related pleural thickening and silica-asbestosis. A 61-year-old man exposed mainly to chrysotile, and also to crocidolite and amosite, had chronic lymphocytic leukemia, pleural plaques and asbestosis. A man who had installed chrysotile brake linings for 25 years was diagnosed with IgG myeloma in March 1977. In February 1978 he was found to have a pleural mesothelioma, and he later died. The first two men were among 26 patients with asbestosis referred for lung disability. In that group of 26, the combined incidence of these two cancers was 7.7 per cent. The authors said this appeared much greater than in the general South African population, but that the number of patients was too small for epidemiologic analysis. They suggested that asbestos-related immune disturbances may predispose people to such cancers and called for a large-scale epidemiologic study.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (three cases), with a brief comparison involving a group of 26 patients with asbestosis
• Who was studied: Three men with heavy occupational asbestos exposure: a 54-year-old black man seen at Johannesburg General Hospital, South Africa, in August 1973; a 61-year-old white man seen in July 1975; and a white man hospitalized in Washington, DC, in March 1977 (his age is printed as '7.1' in the scanned text). The first two were among 26 patients with asbestosis referred for pulmonary disability
• Exposure: Case 1: about three years (1945 to 1948) underground in an amosite asbestos mine in the Transvaal, followed by almost 14 years in coal and gold mines. Case 2: about 13 years as a gold miner, then 28 years as an asbestos milling supervisor at a chrysotile mine in Swaziland, mainly chrysotile, also mixing chrysotile and crocidolite, plus five years of heavy intermittent exposure to crocidolite and amosite while dismantling mills; he also smoked about 20 cigarettes daily for 40 years. Case 3: 25 years of heavy chrysotile exposure installing automobile brake linings
• Main results:
  • Case 1 was diagnosed with IgA myeloma: the bone marrow showed 20 per cent plasma cells, and the serum showed an M component of 2.7 g/dl
  • Case 2 was diagnosed with chronic lymphocytic leukemia; 76 per cent of his circulating lymphocytes were surface IgM-positive, showing the leukemia was of B cell type
  • Cases 1 and 2 had X-ray signs of asbestos-related pleural thickening and parenchymal asbestosis (described as silica-asbestosis in Case 1, who also had healed tuberculosis)
  • Case 3 was diagnosed with IgG myeloma in 1977 and had normal lung and pleura on his first chest X-ray. In February 1978 he had a right pleural effusion, and biopsy showed an epithelial malignant mesothelioma. He later died, and no autopsy was permitted
  • Cases 1 and 2 were among 26 patients with asbestosis referred for pulmonary disability. The combined incidence of the two lymphoid cancers in this group (7.7 per cent) appeared to the authors much greater than in the general South African population (1.1 and 0.8 per 100,000 for chronic lymphocytic leukemia and myeloma, respectively)
• The authors' conclusion: The authors suggested the possibility that asbestos-related immune disturbances may predispose people to immunoproliferative and lymphoproliferative cancers, and said a large-scale epidemiologic study was needed to validate this relationship
• Limitations the authors state:
  • The number of patients was too small for epidemiologic analysis

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Neoplasm, Myeloma, Occupational Exposure, Asbestosis, Pleural Mesothelioma.

Related studies

• Lymphoid and plasma cell malignancies: asbestos-related disorders of long latency — E. Kagan, R.J. Jacobson (1983)
• B cell neoplasms and occupational asbestos exposure — D.A. Schwartz, T.L. Vaughan, et al. (1988)
• Amphibole, but not chrysotile, asbestos induces anti-nuclear autoantibodies and IL-17 in C57BL/6 mice — A. Ferro, C.N. Zebedeo, et al. (2014)
• Plasma cell myeloma presenting with diffuse pleural involvement: a hitherto unreported pattern of a new mesothelioma mimicker — A. Colonna, G. Gualco, et al. (2010)
• Generation of Potent T-cell Immunotherapy for Cancer Using DAP12-Based, Multichain, Chimeric Immunoreceptors — E. Wang, L.C. Wang, et al. (2015)
• High expression of methionine aminopeptidase type 2 in germinal center B cells and their neoplastic counterparts — T. Kanno, H. Endo, et al. (2002)

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