Polymorphism of the erythropoietin gene promotor and the development of myelodysplastic syndromes subsequent to multiple myeloma

AML transformation after autologous stem cell transplant for multiple myeloma

“…Although the underlying biological mechanisms of AML after multiple myeloma are unknown, treatment-related factors, such as alkylating agents and/or anthracyclines, are often accepted to be responsible. More recent reviews have proposed a multifactorial pathogenesis of secondary malignancies in multiple myeloma including disease-related factors like baseline complex cytogenetics3 and type of immunoglobulin secreted,4 host-related factors like polymorphisms in germline genes,5 as well as environmental and behavioural factors in addition to the treatment-related factors 1 2. The incidence of secondary malignancies, including AML, was found to be 5.5% in a Swedish registry database that included 8656 patients with myeloma 6.…”

The impact of prior malignancies on second malignancies and survival in MM patients: a population-based study

“…Smoking is a risk the factor for both cervical cancer and respiratory tract malignancies, 42 although it is not a risk factor for MM. The increased incidence of hematological malignancies, specifically acute myeloid leukemia/MDS, is well documented in MM patients, 4,6,12,13 where alkylating agents have been considered to be 1 of the main contributing factors, although a role for non-treatment-related factors has also been reported, [4][5][6]8 and the recent discovery of a genotype associated with the development of MDS in MM 22 supports a role for susceptibility genes in this development.…”

“…1 These studies have a small number of patients that developed second malignancies, 49 and 59 patients, respectively. Underlying explanation for our findings, that a prior malignancy increases the risk of second malignancies in MM patients, could include genetic susceptibilities, [17][18][19][20][21][22][32][33][34][35] immunosuppression, [36][37][38] and therapy-related cancers. 12,13,39 We found MM patients with a prior cancer diagnosis to have an increased risk of developing hematological malignancy, melanoma, nonmelanoma skin cancer, and respiratory malignancy compared with MM patients who did not.…”

“…18 This might suggest that the genetic cause of MM overlaps with the causes of other cancers. [18][19][20][21][22][23] Information regarding prior malignancies and their impact on MM patients is limited. For instance, patients with prior malignancies are often excluded from clinical trials, 24,25 thus making it difficult to generalize the current literature to this group.…”

Myelodysplasia-associated immunophenotypic alterations of bone marrow cells in myeloma: are they present at diagnosis or are they induced by lenalidomide?

“…Therefore, the incidence of dysplastic features reported in MM after high-dose therapy/autologous stem cell transplantation (HDT/ASCT) (1-13%) [1][2][3][4]16,17 could have been overestimated since some of these may already be present at baseline. 18 Interestingly, up to 20% of all myeloma patients showed an immunophenotypic score that is found only in MDS and not in normal/reactive BM samples (Online Supplementary Table S1). …”