Outcome of Second Primary Malignancies Developing in Multiple Myeloma Patients

被引:6
作者
Avivi, Irit [1 ,2 ]
Vesole, David H. [3 ]
Davila-Valls, Julio [4 ]
Usnarska-Zubkiewicz, Lidia [5 ]
Olszewska-Szopa, Magdalena [5 ]
Milunovic, Vibor [6 ]
Baumert, Bartlomiej [7 ]
Osekowska, Bogumila [7 ]
Kopinska, Anna [8 ]
Gentile, Massimo [9 ,10 ]
Puertas-Martinez, Borja [11 ]
Robak, Pawel [12 ]
Crusoe, Edvan [13 ]
Rodriguez-Lobato, Luis Gerardo [14 ]
Gajewska, Malgorzata [15 ]
Varga, Gergely [16 ]
Delforge, Michel [17 ]
Cohen, Yael [1 ,2 ]
Gozzetti, Alessandro [18 ]
Pena, Camila [19 ]
Shustik, Chaim [20 ]
Mikala, Gabor [21 ]
Zalac, Klara [22 ]
Alexander, H. Denis [23 ]
Barth, Peter [24 ]
Weisel, Katja [25 ]
Martinez-Lopez, Joaquin [26 ]
Waszczuk-Gajda, Anna [27 ]
Krzystanski, Mateusz
Jurczyszyn, Artur [28 ]
机构
[1] Tel Aviv Univ, Tel Aviv Sourasky Med Ctr, Dept Rheumatol, IS-6997801 Tel Aviv, Israel
[2] Tel Aviv Univ, Fac Med, IL-6997801 Tel Aviv, Israel
[3] Hackensack Univ, Med Ctr, Rutgers New Jersey Med Sch, Hackensack, NJ 07601 USA
[4] Hosp Nuestra Senora Sonsoles, Secc Neumol, Avila 05004, Spain
[5] Wroclaw Med Univ, Dept Hematol Blood Neoplasms & Bone Marrow Transpl, PL-50556 Wroclaw, Poland
[6] Clin Hosp Merkur, Div Hematol, Zagreb 10000, Croatia
[7] Pomeranian Med Univ, Dept Gen Pathol, PL-70121 Szczecin, Poland
[8] Med Univ Silesia, Dept Hematol & Bone Marrow Transplantat, PL-40032 Katowice, Poland
[9] AO Cosenza, Hematol Unit, Cosenza, Italy
[10] Univ Calabria, Dept Pharm Hlth & Nutr Sci, I-87036 Arcavacata Di Rende, Italy
[11] Univ Hosp Salamanca, Canc Res Ctr, Inst Invest Biomed Salamanca IBSAL, CIBERONC,IBMCC,USAL,CSIC, Salamanca 37007, Spain
[12] Med Univ Lodz, Copernicus Mem Hosp, Dept Hematol, PL-90752 Lodz, Poland
[13] Univ Fed Bahia, Hosp Univ Prof Edgar Santos, Serv Hematol, BR-40110909 Salvador, BA, Brazil
[14] Hosp Clin Barcelona, Dept Hematol, Amyloidosis & Multiple Myeloma Unit, IDIBAPS, Barcelona 08036, Spain
[15] Mil Inst Med, Dept Internal Med & Hematol, PL-04141 Warsaw, Poland
[16] Semmelweis Univ, Dept Internal Med & Haematol, H-1085 Budapest, Hungary
[17] Univ Hosp UZ Leuven, Dept Pathol, Univ Hosp, B-3000 Leuven, Belgium
[18] Univ Siena, Dept Med Sci Surg & Neurosci, I-53100 Siena, Italy
[19] Hosp Salvador, Secc Hematol, Santiago, Chile
[20] McGill Univ, Royal Victoria Hosp, Urol Dept, Hlth Ctr, Montreal, PQ H4A 3J1, Canada
[21] South Pest Cent Hosp, Natl Inst Hematol & Infect Dis, Dept Hematol & Stem Cell Transplantat, H-1097 Budapest, Hungary
[22] Univ Hosp Ctr Sestre Milosrdnice, Dept Hematol, Clin Internal Med, Zagreb 10000, Croatia
[23] Ulster Univ, Personalised Med Ctr, Sch Med, Derry Londonderry BT47 6SB, North Ireland
[24] Brown Univ, Warren Alpert Med Sch, Dept Med, Providence, RI 02912 USA
[25] Univ Med, Ctr Hamburg Eppendorf, Dept Oncol Hematol & Bone Marrow Transplantat, Sect Pneumol, D-20246 Hamburg, Germany
[26] Nieves Lopez Munoz Hosp, Madrid 28029, Spain
[27] Warsaw Med Univ, Dept Hematol Oncol & Internal Dis, PL-02097 Warsaw, Poland
[28] Jagiellonian Univ Med Coll, Dept Hematol, PL-31155 Krakow, Poland
关键词
second primary malignancy; SPM; multiple myeloma; therapy; LENALIDOMIDE; TRANSPLANTATION; THERAPY;
D O I
10.3390/cancers15174359
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: There is an increased risk of second primary malignancies (SMPs) in patients with multiple myeloma (MM). This multinational 'real-world' retrospective study analyzed the characteristics and outcomes of MM patients that developed SPMs.Results: 165 patients were analyzed: 62.4% males; 8.5% with a prior cancer; 113 with solid SPMs, mainly =stage 2; and 52 with hematological SPM (hemato-SPM), mainly MDS/AML. Patients with hemato-SPM were younger (p = 0.05) and more frequently had a prior AutoHCT (p = 0.012). The time to SPM was shorter in the older (>65 years) and more heavily pretreated patients. One hundred patients were actively treated at the time of SPM detection. Treatment was discontinued in 52, substituted with another anti-MM therapy in 15, and continued in 33 patients. Treatment discontinuation was predominant in the patients diagnosed with hemato-SPM (76%). The median OS following SPM detection was 8.5 months, and the main cause of death was SPM. A poor ECOG status predicted a shorter OS (PS 3 vs. 0, HR = 5.74, 2.32-14.21, p < 0.001), whereas a normal hemoglobin level (HR = 0.43, 0.19-0.95, p = 0.037) predicted longer OS.Conclusions: With the continuing improvement in OS, a higher proportion of MM patients might develop SPM. The OS following SPM diagnosis is poor; hence, frequent surveillance and early detection are imperative to improve outcomes.
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页数:14
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