Investigating additional malignancies rates and overall survival of multiple myeloma patients: a SEER database study

Abstract

Objective The development of effective treatments for multiple myeloma (MM) has resulted in longer surviving of patients. However, these patients are at risk of developing additional malignancies. This study aimed to investigate rates of additional malignancies in MM patients and the median of latency. Findings from this study are expected to improve patient outcomes. Methods Data of MM patients with additional malignancies between 1992 and 2020 was extracted from SEER. The developed of different additional systems and malignancies were analyzed, including solid tumors and hematology. A standardized incidence ratio (SIR) for second primary malignancies (SPMs) was calculated to determine the MM risk. Cox regressions were performed to predict the risk factors associated with MM in patients with additional malignancies. Two nomograms were developed to determine the patient's probability prognosis. Results Regarding different additional malignancies, the most common types of solid tumors of prior malignancies (PMs) and SPMs are prostate cancer. Non-Hodgkin's lymphoma (NHL) as an additional malignancy of MM is the most frequent types of hematology. To construct the diagnostic nomogram, 3676 MM patients with SPMs were included. The nomogram, consisting of six independent risk factors, demonstrated high accuracy with a 3-year survival area under the curve (AUC) of 0.94400 and a 5-year survival AUC of 0.94377. Moreover, 1663 MM patients with PMs were analyzed. The diagnostic nomogram, comprising four independent risk factors, showed moderate accuracy (P < 0.05) with a 3-year survival AUC of 0.62200 and a 5-year survival AUC of 0.61743. Conclusion The present analysis and nomograms are expected to help clinicians in assessing individual survival outcomes of additional malignancies and implementing personalized clinical decisions. Several factors can decrease the survival rate of MM patients with SPMs including bones and joints in solid tumors, hematopoietic system disorders, occurrence of third or subsequent primary malignancies, and advanced age. During the assessment of MM patients with PMs, various parameters should be considered such as advanced age, presence of non-Hodgkin lymphoma, and development of third or subsequent primary malignancies.