scholarly journals Second primary malignancy after multiple myeloma-population trends and cause-specific mortality

2018 ◽  
Vol 182 (4) ◽  
pp. 513-520 ◽  
Author(s):  
Luciano J. Costa ◽  
Kelly N. Godby ◽  
Saurabh Chhabra ◽  
Robert Frank Cornell ◽  
Parameswaran Hari ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Population Trends ◽  
Second Primary ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Specific Mortality

Observations of Second Primary Malignancy in Patients With Multiple Myeloma

2012 ◽  
Vol 12 (2) ◽  
pp. 113-117 ◽  
Author(s):  
Anne Ormerod ◽  
Christopher A. Fausel ◽  
Rafat Abonour ◽  
Patrick J. Kiel
Keyword(s):  
Multiple Myeloma ◽  
Second Primary ◽  
Second Primary Malignancy ◽  
Primary Malignancy

scholarly journals Acute Lymphoblastic Leukemia following Lenalidomide Maintenance for Multiple Myeloma: Two Cases with Unexpected Presentation and Good Prognostic Features

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Abdullah M. Khan ◽  
Jameel Muzaffar ◽  
Hermant Murthy ◽  
John R. Wingard ◽  
Jan S. Moreb
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Acute Lymphoblastic Leukemia ◽  
Bone Marrow Biopsy ◽  
Lymphoblastic Leukemia ◽  
Second Primary ◽  
Cell Transplant ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Prognostic Features

Lenalidomide maintenance following autologous stem cell transplant (ASCT) is considered the standard of care for eligible patients with multiple myeloma (MM). A recent meta-analysis has provided additional evidence that lenalidomide maintenance is associated with a higher incidence of second primary malignancies, including both hematologic and solid malignancies. Acute lymphoblastic leukemia (ALL) as a second primary malignancy is rarely described in the literature. Herein, we describe two patients with MM treated with induction therapy, ASCT, and lenalidomide maintenance that experienced cytopenias while on maintenance. ALL was unexpectedly diagnosed on bone marrow biopsy. One patient was diagnosed on routine biopsy performed as part of requirements of the clinical trial. Both patients had B-cell ALL, without known poor risk cytogenetics, and were managed with standard induction therapies resulting in complete remission. We also reviewed the literature for similar cases of secondary ALL (sALL) in MM patients exposed to immunomodulatory drugs (IMiDs). In conclusion, persistent cytopenias in responding MM patients receiving IMiDs maintenance should be an indication for bone marrow biopsy. Patients develop sALL after median of 32.5 months (range, 20–84) from being on lenalidomide or thalidomide maintenance, often presenting with cytopenias, display low tolerance to chemotherapy, but remission can often be achieved.

A review of second primary malignancy in patients with relapsed or refractory multiple myeloma treated with lenalidomide

Blood ◽  
2012 ◽  
Vol 119 (12) ◽  
pp. 2764-2767 ◽  
Author(s):  
Meletios A. Dimopoulos ◽  
Paul G. Richardson ◽  
Nancy Brandenburg ◽  
Zhinuan Yu ◽  
Donna M. Weber ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Pooled Analysis ◽  
Second Primary ◽  
Separate Analysis ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Pivotal Phase ◽  
Refractory Multiple Myeloma ◽  
Skin Cancers ◽  
Second Primary Malignancies

Abstract In a retrospective pooled analysis of 11 clinical trials of lenalidomide-based therapy for relapsed/refractory multiple myeloma (MM; N = 3846), the overall incidence rate (IR, events per 100 patient-years) of second primary malignancies (SPMs) was 3.62. IR of invasive (hematologic and solid tumor) SPMs was 2.08, consistent with the background incidence of developing cancer. In a separate analysis of pooled data from pivotal phase 3 trials of relapsed or refractory MM (N = 703), the overall IR of SPMs was 3.98 (95% confidence interval [CI], 2.51-6.31) with lenalidomide/dexamethasone and 1.38 (95% CI, 0.44-4.27) with placebo/dexamethasone; IRs of nonmelanoma skin cancers were 2.40 (95% CI, 1.33-4.33) and 0.91 (95% CI, 0.23-3.66), respectively; IRs of invasive SPMs were 1.71 (95% CI, 0.86-3.43) and 0.91 (95% CI, 0.23-3.66), respectively. The risk of SPMs must be taken into account before initiating lenalidomide treatment. In the context of the observed survival benefit in relapsed or refractory MM patients, the benefit/risk profile of lenalidomide/dexamethasone remains positive.

Acute lymphoblastic leukemia as a clonally unrelated second primary malignancy after multiple myeloma

Leukemia ◽  
2018 ◽  
Vol 33 (1) ◽  
pp. 266-270 ◽  
Author(s):  
Ibrahim Aldoss ◽  
Marzia Capelletti ◽  
Jihye Park ◽  
Romanos Sklavenitis Pistofidis ◽  
Raju Pillai ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Second Primary ◽  
Second Primary Malignancy ◽  
Primary Malignancy

Trends in Incidence and Survival of Multiple Myeloma with Second Primary Malignancy,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3958-3958
Author(s):  
Pedram Razavi ◽  
Kristin A Rand ◽  
Sikander Ailawadhi
Keyword(s):  
Multiple Myeloma ◽  
Randomized Clinical Trials ◽  
Conflicts Of Interest ◽  
Temporal Trends ◽  
Second Primary ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Annual Percent Change ◽  
Race Ethnicity ◽  
Second Primary Malignancies

Abstract Abstract 3958 Introduction: Recent advances in the treatment of multiple myeloma (MM) have lead to improved patient outcomes and significant improvement in MM survival. Reports from ongoing randomized clinical trials have suggested that there may be an association between the types of treatment received, particularly certain novel therapeutic agents, and a higher incidence of second primary malignancies (SPM) among MM patients. In this analysis, we explored current patterns and trends in incidence and survival of MM between 1973–2008 to better characterize MM patients with second primary malignancies. Methods: We used data from the National Cancer Institute Surveillance Epidemiology and End Results Program (SEER) to examine the incidence and survival trends in MM by SPM status between 1973–2008. We included all cases with MM as the first primary malignancy and calculated the age-adjusted annual incidence rates (AIR per 100,000) stratified by those with single primary (SP) MM and those with MM as the first of multiple primaries (FMP). All cases that were not microscopically confirmed or those with an MM diagnosis coded only from autopsy- or death certificates were excluded from the analysis. We used joinpoint regression models to calculate the annual percent change (APC) and to determine the best fitting line or set of lines that describes the MM temporal trends. A Monte Carlo permutation method was used to test for significance. We used multivariate Cox proportional hazard models to estimate the hazard ratios (HR) and 95% confidence intervals (95% CI) for MM by SPM status, and all analyses were further stratified by year of diagnosis, age, sex, and race/ethnicity. Results: A total of 61,411 cases of MM were recorded in all SEER registries between the years 1973 and 2008. The final analysis included 49,801 SP and 3090 FMP cases. Overall, the AIR of MM was 5.31 (95% CI 5.26–5.36). The AIR of SP MM was 4.33 (95% CI 4.28–4.38) and 0.28 (95% CI 0.27–0.29) for FMP MM. Compared to women, men were 1.41 times (95% CI 1.38–1.44) and 1.95 times as likely to develop SP MM and FMP MM, respectively. African-Americans had the highest rate of SP MM (AIR 9.09; 95% CI 8.85–9.34) and FMP MM (AIR 0.69; 95% CI 0.62–0.76). We observed no significant trend in AIR of SP MM between 1973–2008 (APC 0.03). The rate of FMP MM was relatively stable, however we observed a small but statistically significant increasing trend in incidence between 1973 and 1992 (APC 2.9), followed by a decreasing trend between 1992 and 2008 (APC −3.2). The rate ratio of FMP to SP MM has remained stable at approximately 6% from 1973–2008. The overall hazard ratio of mortality was 0.59 (95% CI 0.56–0.61) with a median survival of 3.6 years in the FMP MM versus 1.7 years in the SP MM patients. There was a statistically significant improvement in the survival of SP MM patients over the past three decades (P for trend < 0.001), with the most prominent increase in the 2002–2008 period with a HR of 0.67 (95% CI 0.64–0.69) when compared to those diagnosed in the 1973–1981 period. In contrast, the survival of FMP MM patients remained constant (P for trend=0.39). Although SP MM patients show a significant increase in survival over time, FMP MM survival remained stable and significantly higher. We further stratified the survival analysis by age, sex, and race/ethnicity. In all stratified analyses, FMP MM patients had a significantly better outcome compared to SP MM patients. Conclusions: Although there has been significant improvement in survival for patients with SP MM in recent years, our results provide an epidemiologic evidence suggestive of a subtype of MM with a better outcome, yet a higher risk of secondary primary malignancies. The incidence rate and outcome of this possible subtype has remained unchanged over the last three decades. These findings are replicated when stratified by gender, race, age, and year of diagnosis. Recent advancements of MM treatment have seemed to only increase the survival of SP MM patients, while the survival of FMP MM patients remained stable. Further studies are needed to explore the potential genetic heterogeneity between MM with and without second primary malignancies. Disclosures: No relevant conflicts of interest to declare.

Multiple myeloma as a second primary malignancy; one fourth of patients had prior history of other malignances

2015 ◽  
Vol 15 ◽  
pp. e113 ◽  
Author(s):  
N. Nishimura ◽  
Y. Terui ◽  
N. Inoue ◽  
A. Takahashi ◽  
N. Tsuyama ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Prior History ◽  
Second Primary ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
History Of

scholarly journals Variable risk of second primary malignancy in multiple myeloma patients of different ethnic subgroups

2014 ◽  
Vol 4 (9) ◽  
pp. e243-e243 ◽  
Author(s):  
S Ailawadhi ◽  
A Swaika ◽  
P Razavi ◽  
D Yang ◽  
A Chanan-Khan
Keyword(s):  
Multiple Myeloma ◽  
Second Primary ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Ethnic Subgroups
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