Acute Leukemia after Multiple Myeloma: A Case Report with Review of the Literature

Abstract

The occurrence of acute leukemia after treated multiple myeloma has long raised concerns and has been the subject of several studies which have been based mainly on the link with treatments, mainly those using alkylating agents, but they remain limited due to the small number of patients, insufficient follow-up and limits for detecting second malignant tumors. Although the underlying biological mechanisms of AML after multiple myeloma are unknown, treatment-related factors are believed to be responsible. Recently, an excessive risk of acute leukemia has been found among 5652 patients with monoclonal gammopathy of undetermined significance IgG / IgA (but not IgM) supporting the role of disease-related factors. In addition, there is evidence to suggest that genetic polymorphisms may contribute to a person's susceptibility to future cancers, while the potential influence of environmental and behavioral factors remains poorly understood. This article discusses, through the observation of our patient, the current knowledge concerning malignant tumors after multiple myeloma and gives future directions for efforts to characterize the underlying biological mechanisms, with the aim of increasing survival and minimize the risk of new malignancies.