The simple answer is that multiple myeloma is not considered an inherited cancer in the traditional sense. You don't inherit myeloma directly from a parent, and there isn't one specific "myeloma gene" that determines whether someone will develop the disease.
However, genetics may still play a role.
Family History Can Increase Risk
Research has found that people with a first-degree relative—a parent, sibling, or child—with multiple myeloma have a higher risk of developing myeloma themselves compared with someone without that family history.
That can sound frightening, but it's important to put the increase in perspective.
Multiple myeloma is still a relatively uncommon cancer. Even when a person's relative has myeloma, the absolute chance that they will develop the disease remains low.
In other words, having myeloma in your family does not mean other family members are destined to develop it.
So, What Is Being Inherited?
Scientists have identified a number of inherited genetic variations associated with an increased susceptibility to multiple myeloma and its precursor condition, MGUS (monoclonal gammopathy of undetermined significance).
These genetic differences don't directly cause myeloma. Instead, they may make someone slightly more susceptible to developing the biological changes that can eventually lead to the disease.
Think of genetics as one piece of a much larger puzzle.
Age, ancestry, environmental exposures, changes that occur within plasma cells over a person's lifetime, and other factors that researchers are still trying to understand may all contribute.
What About MGUS?
Nearly all cases of multiple myeloma are preceded by MGUS, although most people with MGUS will never develop multiple myeloma.
That makes MGUS particularly important to researchers.
Instead of waiting until someone develops active myeloma, scientists can study people with MGUS—or those who have a greater likelihood of developing it—to better understand why the condition progresses in some people but remains harmless in many others.
The PROMISE Study
One important research project is the PROMISE Study, which is investigating people who may have a higher risk of developing multiple myeloma.
The study has included individuals with a first-degree relative who has multiple myeloma or another blood cancer, as well as Black/African American individuals, because multiple myeloma and MGUS occur more frequently in this population.
Researchers hope that identifying MGUS and studying people at increased risk will eventually help us better understand who develops myeloma, why progression occurs, and whether earlier intervention could someday prevent active disease.
Should Family Members Be Tested?
At this time, routine genetic testing or screening for every relative of someone with multiple myeloma is not generally recommended simply because myeloma runs in the family.
However, people with a strong family history may want to discuss it with their healthcare provider. Research programs such as PROMISE may also provide screening opportunities for people who meet their eligibility requirements.
The Bottom Line
Multiple myeloma isn't directly inherited, but susceptibility to developing it can run in families.
Having a parent, sibling, or child with myeloma may increase your risk compared with the general population, but the overall likelihood of developing the disease remains relatively small.
Research into inherited risk, MGUS, and the earliest biological changes leading to myeloma continues to grow. What scientists learn may eventually allow us to identify people at greater risk much earlier—and perhaps one day stop myeloma before it ever becomes active disease.
https://www.enroll.promisestudy.org/
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