Publication: Increasing Therapy Related Myeloid Neoplasms in Multiple Myeloma
Authors
Fernández-Caballero, M ; Salmerón, D ; Chen-Liang, TH ; Hurtado, AM ; García Malo, MD ; Ortuño, FJ ; Roldán, V ; Vicente, V ; Jerez, A ; De Arriba, F ; Chirlaque López, María Dolores
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Publisher
Wiley
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DOI
https://doi.org/10.1111/eci.13050
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info:eu-repo/semantics/article
Description
© 2018 Stichting European Society for Clinical Investigation Journal Foundation. This document is made available under the CC-BY-NC 4.0 license http://creativecommons.org/licenses/by-nc /4.0/
This document is the submitted version of a published work that appeared in final form in European Journal of Clinical Investigation.
Abstract
Background: Despite the longer survival achieved in multiple myeloma (MM)
patients due to new therapy strategies, a concern is emerging regarding an
increased risk of secondary primary malignancies (SPMs) and how to characterize
those patients at risk. We performed a retrospective study covering a 28‐year follow‐
up period (1991‐2018) in a tertiary single institution.
Material and Methods: Data of 403 MM patients were recorded and compared
with the epidemiologic register of the population area covered by our centre, calculating
the standardize incidence ratio (SIR) for the different types of SPMs
diagnosed in the MM cohort. Fine and Gray regression models were used to identify
risk factors for SPMs.
Results: Out of the 403 MM patients, 23 (5.7%) developed SPMs: 13 therapyrelated
myeloid (TRM) malignancies (10 of them (77%) myelodysplastic syndrome
(MDS), 1 acute lymphoid leukaemia and 9 solid neoplasms. In the MM cohort, the
relative risk of MDS was significantly higher than in the general population. Survival
of patients with TRM malignancies was poor with a median of 4 months from
the diagnosis, and most of them showed complex karyotype. Within the MM subset,
multivariable analysis showed a higher risk of TRM malignancies in patients that
previously received prolonged treatment with lenalidomide (>18 months).
Conclusions: Though the improvement in MM outcome during the last decades
is an unprecedented achievement, it has been accompanied by the rise in TRM
malignancies with complex cytogenetic profile and poor prognosis that are in the
need of an improved biologic and therapeutic approach.
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Citation
European Journal of Clinical InvestigationVolume 49, Issue 2 e13050
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