Second primary malignancies in multiple myeloma: an overview and IMWG consensus

被引：116

作者：

Musto, P. ^{[1
]}

Anderson, K. C. ^{[2
]}

Attal, M. ^{[3
]}

Richardson, P. G. ^{[2
]}

Badros, A. ^{[4
]}

Hou, J. ^{[5
]}

Comenzo, R. ^{[6
]}

Du, J.

Durie, B. G. M. ^{[7
]}

San Miguel, J. ^{[8
]}

Einsele, H. ^{[9
]}

Chen, W. M. ^{[10
]}

Garderet, L. ^{[11
]}

Pietrantuono, G. ^{[12
]}

Hillengass, J. ^{[13
,14
]}

Kyle, R. A. ^{[15
]}

Moreau, P. ^{[16
]}

Lahuerta, J. J. ^{[17
]}

Landgren, O. ^{[18
]}

Ludwig, H. ^{[19
]}

Larocca, A. ^{[20
]}

Mahindra, A. ^{[21
]}

Cavo, M. ^{[22
]}

Mazumder, A. ^{[23
]}

McCarthy, P. L. ^{[24
]}

Nouel, A. ^{[25
]}

Rajkumar, S. V. ^{[15
]}

Reiman, A. ^{[26
]}

Serra, E. R. ^{[27
]}

Sezer, O. ^{[28
]}

Terpos, E. ^{[29
]}

Turesson, I. ^{[30
]}

Usmani, S. ^{[31
]}

Weiss, B. M. ^{[32
]}

Palumbo, A. ^{[20
]}

机构：

[1] IRCCS CROB, Referral Canc Ctr Basilicata, Sci Direct, Via Padre Pio 1, I-85028 Rionero In Vulture, Pz, Italy

[2] Dana Farber Canc Inst, Hematol Oncol, Boston, MA 02115 USA

[3] Inst Univ Canc Toulouse Oncopole, Hematol, Toulouse, France

[4] Univ Maryland, Sch Med, Baltimore, MD 21201 USA

[5] Second Mil Med Univ, Changzheng Hosp, Myeloma & Lymphoma Ctr, Dept Hematol, Shanghai, Peoples R China

[6] Tufts Med Ctr, Hematol Oncol, Boston, MA USA

[7] Cedars Sinai Med Ctr, Samuel Oschin Canc Ctr, Los Angeles, CA 90048 USA

[8] Univ Navarra Clin, CIMA, Pamplona, Spain

[9] Univ Hosp Wuerzburg, Internal Med 2, Wurzburg, Germany

[10] Capital Med Univ, Beijing Chaoyang Hosp, Beijing, Peoples R China

[11] Hop St Antoine, Hematol Clin, Paris, France

[12] Referral Canc Ctr Basilicata, IRCCS CROB, Unit Hematol & Stem Cell Transplantat, Rionero In Vulture, Italy

[13] Heidelberg Univ, Dept Hematol & Oncol, Heidelberg, Germany

[14] German Canc Res Ctr, Heidelberg, Germany

[15] Mayo Clin, Dept Lab Med & Pathol, Rochester, MN USA

[16] Univ Hosp, Hematol, Nantes, France

[17] Hosp Univ 12 Octubre, Spanish Myeloma Grp, Madrid, Spain

[18] Mem Sloan Kettering Canc Ctr, Hematol Oncol, 1275 York Ave, New York, NY 10021 USA

[19] Wilhelminenspital Stat Wien, Med Dept & Oncol 1, Vienna, Austria

[20] Univ Torino, Div Hematol, Azienda Osped Univ Citta Salute & Sci Torino, Turin, Italy

[21] Univ Calif San Francisco, Sch Med, San Francisco, CA USA

[22] Univ Bolgona, Dept Specialized Expt & Diagnost Med, Bologna, Italy

[23] NYU Comprehens Canc Ctr, Med Oncol, New York, NY USA

[24] Roswell Pk Canc Ctr, Dept Med, Buffalo, NY USA

[25] Hosp Univ Rutz & Paez, Dept Hematol, Bolivar, Venezuela

[26] St Johns Hosp, Dept Oncol, St John, NB, Canada

[27] Hosp Clin Montevideo, Dept Hematol, Montevideo, Uruguay

[28] Mem Hosp, Dept Hematol, Istanbul, Turkey

[29] Natl & Kapodistrian Univ Athens, Sch Med, Athens, Greece

[30] Skane Univ Hosp, Dept Hematol & Coagulat Disorders, Malmo, Sweden

[31] Carolinas Healthcare Syst, Levine Canc Inst, Charlotte, NC USA

[32] Univ Penn, Abramson Canc Ctr, Philadelphia, PA 19104 USA

来源：

ANNALS OF ONCOLOGY | 2017年 / 28卷 / 02期

关键词：

multiple myeloma; second primary malignancy; SPM; risk factors; lenalidomide; International Myeloma Working Group; STEM-CELL TRANSPLANTATION; BORTEZOMIB-MELPHALAN-PREDNISONE; SECONDARY PRIMARY MALIGNANCIES; HIGH-DOSE CHEMOTHERAPY; MYELODYSPLASTIC SYNDROME; AUTOLOGOUS TRANSPLANTATION; LENALIDOMIDE MAINTENANCE; DARATUMUMAB MONOTHERAPY; MYELOMONOCYTIC LEUKEMIA; INELIGIBLE PATIENTS;

D O I：

10.1093/annonc/mdw606

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Therapeutic advancements following the introduction of autologous stem cell transplantation and ` novel' agents have significantly improved clinical outcomes for patients with multiple myeloma (MM). Increased life expectancy, however, has led to renewed concerns about the long-term risk of second primary malignancies (SPMs). This review outlines the most up-to-date knowledge of possible host-, disease-, and treatment-related risk factors for the development of SPMs in patients with MM, and provides practical recommendations to assist physicians. Design: A Panel of International Myeloma Working Group members reviewed the most relevant data published in the literature as full papers, or presented at meetings of the American Society of Clinical Oncology, American Society of Hematology, European Hematology Association, or International Myeloma Workshops, up to June 2016. Here, we present the recommendations of the Panel, based on this literature review. Results: Overall, the risk of SPMs in MM is low, multifactorial, and partially related to the length of patients' survival and MM intrinsic susceptibility. Studies suggest a significantly increased incidence of SPMs when lenalidomide is administered either following, or concurrently with, oral melphalan. Increased SPM incidence has also been reported with lenalidomide maintenance following high-dose melphalan, albeit to a lesser degree. In both cases, the risk of death from MM was significantly higher than the risk of death from SPMs, with lenalidomide possibly providing a survival benefit. No increase in SPM incidence was reported with lenalidomide plus dexamethasone (without melphalan), or with bortezomib plus oral melphalan, dexamethasone, or thalidomide. Conclusion: In general, the risk of SPMs should not alter the current therapeutic decision- making process in MM. However, regimens such as lenalidomide plus dexamethasone should be preferred to prolonged exposure to lenalidomide plus oral melphalan. SPM risk should be carefully discussed with the patient in the context of benefits and risks of different treatment options.

引用

页码：228 / 245

页数：18

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