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Langseth ØO, Myklebust TÅ, Johannesen TB, Hjertner Ø, Waage A. Patterns of previous and secondary malignancies in patients with multiple myeloma. Eur J Haematol 2021; 106:529-536. [PMID: 33455012 DOI: 10.1111/ejh.13581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/04/2020] [Accepted: 01/12/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVES In contrast to secondary primary malignancies (SPM) following multiple myeloma (MM), less is known about previous malignancies. We therefore conducted a population-based study to assess the patterns of previous malignancies in MM patients as well as the risk for SPM. METHODS Using data from the Cancer Registry of Norway, we included 9574 MM patients and 37 810 matched control subjects. The association between previous malignancies and a subsequent diagnosis of MM was analysed by a logistic regression model and the risk for SPM by a Cox model. RESULTS A previous diagnosis of myeloproliferative neoplasia (MPN) (OR 3.57; 95% CI:1.45-8.80) and Hodgkin lymphoma (HL) (OR 3.66; 95% CI: 1.40-9.55) was associated with the subsequent development of MM. For MPN, the association with MM was explained by an excess of primary myelofibrosis (PMF) in the MM group. The overall incidence of a previous malignancy was not different between MM patients and the control subjects (OR 0.93; 95% CI: 0.87-1.00). MM patients had an increased risk for secondary acute myelogenous leukaemia/myelodysplastic syndromes (HR 6.1, 95% CI: 3.9-9.5). CONCLUSIONS A previous diagnosis of HL and PMF was associated with a subsequent diagnosis of MM, whereas the overall incidence of previous cancers was not increased for MM patients.
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Affiliation(s)
- Øystein O Langseth
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,The Cancer Clinic, St. Olav's University Hospital, Trondheim, Norway
| | - Tor Å Myklebust
- Department of Registration, Cancer Registry of Norway, Oslo, Norway.,Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Tom B Johannesen
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
| | - Øyvind Hjertner
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Hematology, St. Olav's University Hospital, Trondheim, Norway
| | - Anders Waage
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Hematology, St. Olav's University Hospital, Trondheim, Norway
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Wang Y, Wu Y, Xu Z, Zhou H, Chen Y, Zhan R. Cytogenetic abnormalities in patients with newly diagnosed multiple myeloma as a secondary primary malignancy: a retrospective study. ACTA ACUST UNITED AC 2020; 25:176-180. [PMID: 32345147 DOI: 10.1080/16078454.2020.1757330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Objectives: Multiple myeloma (MM) often develops as a secondary primary malignancy (SPM). The retinoblastoma susceptibility gene (RB1) was the first tumour suppressor gene to be identified. We pooled and analyzed available data to compare the incidence of RB1 gene deletions and other cytogenetic abnormalities in patients with MM alone or as an SPM.Methods: We conducted a retrospective study of 475 patients. The experimental group comprised 18 patients with MM as an SPM, and the control group comprised 457 MM patients. We analyzed the baseline information in both groups, and used the odds ratio (OR), 95% confidence interval (CI), and forest plot to determine the incidence of SPMs with and without cytogenetic abnormalities.Results: The incidence of RB1 gene deletion was higher in the experimental group. There was no significant difference in other cytogenetic abnormalities.Conclusions: RB1 gene deletions appear to be associated with MM that develops as an SPM.
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Affiliation(s)
- Yiting Wang
- Fujian Institute of Hematology, Fuzhou, People's Republic of China
| | - Yong Wu
- Fujian Institute of Hematology, Fuzhou, People's Republic of China
| | - Zhenshu Xu
- Fujian Institute of Hematology, Fuzhou, People's Republic of China
| | - Huarong Zhou
- Fujian Institute of Hematology, Fuzhou, People's Republic of China
| | - Yuanzhong Chen
- Fujian Institute of Hematology, Fuzhou, People's Republic of China
| | - Rong Zhan
- Fujian Institute of Hematology, Fuzhou, People's Republic of China
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Munker R, Baghian A, Koleva Y, Andrews P, Matharoo GS, Wright AE, Saba NS, Weiner RS, Safah H. Long-term follow-up of patients with multiple myeloma treated with total body irradiation-Melphalan conditioning. Eur J Haematol 2017; 99:56-59. [PMID: 28370630 DOI: 10.1111/ejh.12890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Since a study published in 2002 showed a survival advantage of melphalan-only conditioning for stem cell transplantation (HSCT) over melphalan-total body irradiation (mel-TBI) in patients with multiple myeloma (MM), most centers abandoned mel-TBI. Mel-TBI causes more early toxicity and is more complicated to administer, but we speculated it may result in longer term survival with radiation as an independent treatment modality. Therefore, we analyzed the long-term outcome of patients with MM who received mel-TBI as part of conditioning at our center. PATIENTS AND METHODS From 1995 to 2013, 50 patients with MM underwent autologous HSCT at Tulane University Medical Center using mel-TBI conditioning. We used Kaplan-Meier survival analysis and compared our patients with data available from the Louisiana Tumor Registry. RESULTS The mean survival of our patients was 70.98 months from time of transplant and 84.2 months from time of initial diagnosis. No differences were observed according to gender, ethnicity, or age at transplant. The expected median survival in a population-based registry (matched for age and year of treatment) was 27 months (P<.001). CONCLUSIONS Total body irradiation in conjunction with melphalan as conditioning is feasible and can lead to long-term survival. More research is necessary to determine which patients benefit most. Mel-TBI should also be explored in conjunction with immunotherapy.
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Affiliation(s)
- Reinhold Munker
- Department of Medicine (Hematology/Oncology), Tulane University Medical Center, New Orleans, LA, USA
| | - Ali Baghian
- Department of Medicine (Hematology/Oncology), Tulane University Medical Center, New Orleans, LA, USA
| | - Yordanka Koleva
- Department of Medicine (Hematology/Oncology), Tulane University Medical Center, New Orleans, LA, USA
| | - Patricia Andrews
- Louisiana Tumor Registry, LSU School of Public Health, New Orleans, LA, USA
| | - Gunita S Matharoo
- School of Public Health, Tulane University Medical Center, New Orleans, LA, USA
| | - Ato E Wright
- Department of Radiation Oncology, Tulane University Medical Center, New Orleans, LA, USA
| | - Nakhle S Saba
- Department of Medicine (Hematology/Oncology), Tulane University Medical Center, New Orleans, LA, USA
| | - Roy S Weiner
- Department of Medicine (Hematology/Oncology), Tulane University Medical Center, New Orleans, LA, USA
| | - Hana Safah
- Department of Medicine (Hematology/Oncology), Tulane University Medical Center, New Orleans, LA, USA
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Musto P, Anderson K, Attal M, Richardson P, Badros A, Hou J, Comenzo R, Du J, Durie B, San Miguel J, Einsele H, Chen W, Garderet L, Pietrantuono G, Hillengass J, Kyle R, Moreau P, Lahuerta J, Landgren O, Ludwig H, Larocca A, Mahindra A, Cavo M, Mazumder A, McCarthy P, Nouel A, Rajkumar S, Reiman A, Riva E, Sezer O, Terpos E, Turesson I, Usmani S, Weiss B, Palumbo A. Second primary malignancies in multiple myeloma: an overview and IMWG consensus. Ann Oncol 2017; 28:228-245. [DOI: 10.1093/annonc/mdw606] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Mizutani S, Kuroda J, Sasaki N, Kiyota M, Tatekawa S, Tsukamoto T, Maegawa S, Chinen Y, Shimura Y, Nagoshi H, Kobayashi T, Horiike S, Tando S, Fushiki S, Taniwaki M. Quadruple Cancers of Non-producing Multiple Myeloma, Cholangiocellular Carcinoma, and Two Different Thyroid Cancers. Intern Med 2016; 55:1183-6. [PMID: 27150876 DOI: 10.2169/internalmedicine.55.5319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We report the case of a 72-year-old man who presented with non-producing multiple myeloma (MM) with three additional concomitant solid tumors that were identified by postmortem autopsy. The disease was refractory to anti-MM therapy including bortezomib and lenalidomide, and he finally died of bacterial pneumonia with diffuse alveolar damage 8 months after the diagnosis. An autopsy revealed that he was also affected by three other solid cancers, cholangiocellular carcinoma, medullary thyroid cancer and papillary thyroid cancer that were clinically asymptomatic and remained undiagnosed before death. A review of the literature suggests that primary quadruple cancers including MM are extremely rare.
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Affiliation(s)
- Shinsuke Mizutani
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Japan
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Munker R, Shi R, Nair B, Devarakonda S, Cotelingam JD, McLarty J, Mills GM, Glass J. The Shreveport Myeloma Experience: Survival, Risk Factors and Other Malignancies in the Age of Stem Cell Transplantation. Acta Haematol 2015; 135:146-55. [PMID: 26588024 DOI: 10.1159/000440970] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 09/06/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND The overall prognosis of multiple myeloma has improved significantly over the last 15 years. We wondered whether the overall improvement would also be seen in unselected patients in an academic center in Northwest Louisiana with a high proportion of minority patients, and if second malignant neoplasms are relevant for our patients. MATERIALS AND METHODS Between 1998 and 2009, 215 patients were treated for multiple myeloma at our center and had complete follow-up until May 2013. RESULTS The mean survival of patients with multiple myeloma increased from 3.25 to 5.34 years, which is comparable to patients treated at larger centers. No prognostic difference was observed in the subgroups of myeloma patients. Among 215 patients followed for the development of secondary cancers, 16 already had a preexisting or concomitant malignancy (7.4%) and 10 developed secondary cancers. Our data indicate a significant background of histologically unrelated cancers and a cumulative incidence of new cancers of about 20% after 10 years of follow-up. Based on SEER data, preexisting or secondary cancers were not statistically increased in our population. CONCLUSIONS The use of autologous transplantation and the introduction of new agents resulted in a significant improvement in the prognosis of multiple myeloma. Other cancers are not statistically increased before or after multiple myeloma is diagnosed and are not prognostically relevant.
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Hepatic Extramedullary Disease in Multiple Myeloma With 17p Deletion. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2014; 14:e165-8. [DOI: 10.1016/j.clml.2014.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/01/2014] [Accepted: 04/03/2014] [Indexed: 11/23/2022]
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Engelhardt M, Wäsch R, Landgren O, Kleber M. Multiple myeloma and second malignancies. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2013; 14:98-101. [PMID: 24445186 DOI: 10.1016/j.clml.2013.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 11/17/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Monika Engelhardt
- Department of Hematology and Oncology, University of Freiburg Medical Center, Freiburg, Germany
| | - Ralph Wäsch
- Department of Hematology and Oncology, University of Freiburg Medical Center, Freiburg, Germany
| | - Ola Landgren
- Multiple Myeloma Section, Metabolism Branch, National Cancer Institute, Bethesda, MD
| | - Martina Kleber
- Department of Hematology and Oncology, University of Freiburg Medical Center, Freiburg, Germany
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