TY - JOUR
T1 - Risk of secondary primary malignancies in multiple myeloma patients with or without autologous stem cell transplantation
AU - For the Fukuoka Blood and Marrow Transplantation Group
AU - Yamasaki, Satoshi
AU - Yoshimoto, Goichi
AU - Kohno, Kentaro
AU - Henzan, Hideho
AU - Aoki, Takatoshi
AU - Tanimoto, Kazuki
AU - Sugio, Yasuhiro
AU - Muta, Tsuyoshi
AU - Kamimura, Tomohiko
AU - Ohno, Yuju
AU - Ogawa, Ryosuke
AU - Eto, Tetsuya
AU - Nagafuji, Koji
AU - Miyamoto, Toshihiro
AU - Akashi, Koichi
AU - Iwasaki, Hiromi
N1 - Publisher Copyright:
© 2018, The Japanese Society of Hematology.
PY - 2019/1/22
Y1 - 2019/1/22
N2 - Outcomes for patients with multiple myeloma (MM) have improved through use of novel treatments, especially lenalidomide combined with autologous stem cell transplantation. However, because of their increased life expectancy, an increased risk of secondary primary malignancies (SPMs) has been observed in MM patients, particularly after lenalidomide maintenance in both transplant-eligible (TE) and transplant-ineligible (TI) patients. To evaluate the incidence and risk factors of developing SPMs, we identified 17 TE-MM and 12 TI-MM patients with SPMs among 211 TE-MM and 280 TI-MM patients, including seven TE-MM and four TI-MM patients with hematological malignancies and ten TE-MM and eight TI-MM patients with non-hematological cancers, respectively. The median follow-up time from diagnosis was > 4 years. Multivariate analysis identified a history of high-dose cyclophosphamide use for peripheral blood stem cell harvest in TE-MM patients and > 65 years of age at diagnosis, or a history of adriamycin, lenalidomide, or thalidomide use in TI-MM patients as independent risk factors for SPMs (P < 0.001). Patients with a history of lenalidomide use had a lower risk of death among both TE-MM (P = 0.0326) and TI-MM (P < 0.001) patients. The survival benefit of receiving lenalidomide outweighed the increased risk of SPMs in both TE-and TI-MM patients.
AB - Outcomes for patients with multiple myeloma (MM) have improved through use of novel treatments, especially lenalidomide combined with autologous stem cell transplantation. However, because of their increased life expectancy, an increased risk of secondary primary malignancies (SPMs) has been observed in MM patients, particularly after lenalidomide maintenance in both transplant-eligible (TE) and transplant-ineligible (TI) patients. To evaluate the incidence and risk factors of developing SPMs, we identified 17 TE-MM and 12 TI-MM patients with SPMs among 211 TE-MM and 280 TI-MM patients, including seven TE-MM and four TI-MM patients with hematological malignancies and ten TE-MM and eight TI-MM patients with non-hematological cancers, respectively. The median follow-up time from diagnosis was > 4 years. Multivariate analysis identified a history of high-dose cyclophosphamide use for peripheral blood stem cell harvest in TE-MM patients and > 65 years of age at diagnosis, or a history of adriamycin, lenalidomide, or thalidomide use in TI-MM patients as independent risk factors for SPMs (P < 0.001). Patients with a history of lenalidomide use had a lower risk of death among both TE-MM (P = 0.0326) and TI-MM (P < 0.001) patients. The survival benefit of receiving lenalidomide outweighed the increased risk of SPMs in both TE-and TI-MM patients.
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U2 - 10.1007/s12185-018-2538-8
DO - 10.1007/s12185-018-2538-8
M3 - Article
C2 - 30251131
AN - SCOPUS:85053799795
SN - 0925-5710
VL - 109
SP - 98
EP - 106
JO - International Journal of Hematology
JF - International Journal of Hematology
IS - 1
ER -
