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Risk of secondary primary malignancies in multiple myeloma patients with or without autologous stem cell transplantation

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Abstract

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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Acknowledgements

We thank the patients and clinical staff for their participation in the study. The authors also acknowledge Kyushu Medical Hospital for their editorial support. We also thank Jodi Smith, PhD, and Mitchell Arico from Edanz Group (http://www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

There is no funding source.

Author information

Authors and Affiliations

  1. Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan

    Satoshi Yamasaki & Hiromi Iwasaki

  2. Department of Hematology/Oncology, Kyushu University Hospital, Fukuoka, Japan

    Goichi Yoshimoto, Toshihiro Miyamoto & Koichi Akashi

  3. Department of Hematology/Oncology, Japan Community Health Care Organization Kyushu Hospital, Fukuoka, Japan

    Kentaro Kohno & Ryosuke Ogawa

  4. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    Hideho Henzan & Tetsuya Eto

  5. Department of Hematology, Harasanshin Hospital, Fukuoka, Japan

    Takatoshi Aoki & Tomohiko Kamimura

  6. Department of Hematology, Fukuoka Red Cross Hospital, Fukuoka, Japan

    Kazuki Tanimoto

  7. Department of Internal Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan

    Yasuhiro Sugio & Yuju Ohno

  8. Department of Hematology, Kurume University Hospital, Kurume, Japan

    Koji Nagafuji

  9. Department of Hematology, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan

    Tsuyoshi Muta

Authors
  1. Satoshi Yamasaki
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  2. Goichi Yoshimoto
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  3. Kentaro Kohno
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  4. Hideho Henzan
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  5. Takatoshi Aoki
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  6. Kazuki Tanimoto
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  7. Yasuhiro Sugio
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  8. Tsuyoshi Muta
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  9. Tomohiko Kamimura
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  10. Yuju Ohno
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  11. Ryosuke Ogawa
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  12. Tetsuya Eto
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  13. Koji Nagafuji
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  14. Toshihiro Miyamoto
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  15. Koichi Akashi
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  16. Hiromi Iwasaki
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For the Fukuoka Blood and Marrow Transplantation Group

Contributions

SY contributed to the study design, data analysis, and manuscript preparation. GY, KK, HH, TA, KT, YS, TM, TK, YO, RO, TE, KN, TM, KA, and HI reviewed the manuscript.

Corresponding author

Correspondence to Satoshi Yamasaki.

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The authors declare that they have no conflicts of interest.

Additional information

All authors of this manuscript belong to FBMTG.

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Yamasaki, S., Yoshimoto, G., Kohno, K. et al. Risk of secondary primary malignancies in multiple myeloma patients with or without autologous stem cell transplantation. Int J Hematol 109, 98–106 (2019). https://doi.org/10.1007/s12185-018-2538-8

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  • DOI: https://doi.org/10.1007/s12185-018-2538-8

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