Patterns of previous and secondary malignancies in patients with multiple myeloma

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.

Ruxolitinib as a primary treatment for multiple myeloma in a patient with primary myelofibrosis? A case report and the review of the literature

“…Interestingly, PMF patients are significantly more likely to develop AML (HR = 99.2), lymphoma (HR = 6.0), and MM (HR = 9.0) than patients suffering from other MPNs [19]. Following the study, there is an association between the subsequent appearance of MM in patients previously diagnosed with PMF [20].…”

Prior cancer and risk of monoclonal gammopathy of undetermined significance: a population-based study in Iceland and Sweden

“…Furthermore, they found myeloid cancer to be associated with a higher risk of MM, the opposite finding of our study. 11 In contrast to this prior study, the current study is based on a screened cohort and long-term follow-up of a large MGUS cohort providing an unbiased epidemiological view of the pathogenesis of MM and related disorders. Furthermore, the prior study was affected by important potential biases including detection of low-grade myeloproliferative disorders in the work-up leading to the diagnosis of MM (a phenomenon we have observed in diabetes 21 ) and misclassification of MM bone lesions as solid tumor metastasis.…”

“…There is limited epidemiological evidence that having a solid and myeloid cancer decreases and increases the risk of MM respectively. 11 Similar, conflicting results have been found in the patterns of cancers in family members of those who have had WM. 12 In contrast, other LPs, in particular chronic lymphocytic leukaemia (CLL) has been associated with prior cancer.…”

Time trends in survival and causes of death in multiple myeloma: a population-based study from Germany

“…Firstly, an increase of mortality from age-related diseases is to be expected in an aging population. Secondly, after prolonged exposition to cytostatic and/ or immunomodulatory therapy, the risk of secondary primary malignancies (SPM) as well as the risk of fatal outcomes due to late-occurring side effects and cumulative toxicity might increase [14][15][16]. Hence, a comprehensive analysis of the causes of death among MM patients provides valuable information about potentially fatal secondary risks outside of RCTs and might contribute to their early prevention.…”