Increased mortality risk in multiple-myeloma patients with subsequent malignancies: a population-based study in the Netherlands

Brink, Mirian; Minnema, Monique C.; Visser, Otto; Levin, Mark‐David; Posthuma, Eduardus F M; Broijl, Annemiek; Sonneveld, Pieter; Klift, Marjolein van der; Roeloffzen, Wilfried; Westerman, Matthijs; Rooijen, Cleo R. van; Geerts, Paul A. F.; Donk, Niels W.C.J. van de; Dinmohamed, Avinash G.

doi:10.1038/s41408-022-00640-6

Cited by 8 publications

(11 citation statements)

References 15 publications

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“…In our analysis, MM patients were more likely to die from cardiovascular diseases or from non-myeloma malignancies (including SPM) compared to the general population. While in earlier studies the overall risk of SPM was not increased in MM patients [38], population-based studies have shown an increase in the incidence of SPM in recent years due to longer survival and possibly linked to the administration of lenalidomide and melphalan [16,39]. Consistent with our findings, an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) Program found a proportion of non-myeloma cancer deaths in MM patients of 5.4% and showed a more than twofold increase in the risk of death from cardiovascular diseases in MM patients compared to the general population [15].…”

Section: Discussionmentioning

confidence: 86%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Eisfeld

Kajüter²,

Möller³

et al. 2023

BMC Cancer

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Background Steady evolution of therapies has improved prognosis of patients with multiple myeloma (MM) over the past two decades. Yet, knowledge about survival trends and causes of death in MM might play a crucial role in long-term management of this patient collective. Here, we investigate time trends in myeloma-specific survival at the population level over two decades and analyse causes of death in times of prolonged survival. Methods Age-standardised and age group-specific relative survival (RS) of MM patients aged < 80 years at diagnosis was estimated for consecutive time periods from 2000–2019 using data from the Cancer Registry of North Rhine-Westphalia in Germany. Conditional RS was estimated for patients who already survived one to five years post diagnosis. Causes of death in MM patients were analysed and compared to the general population using standardised mortality ratios (SMR). Results Three thousand three hundred thirty-six MM cases were included in the time trend analysis. Over two decades, age-standardised 5-year RS increased from 37 to 62%. Age-specific survival improved from 41% in period 2000–2004 to 69% in period 2015–2019 in the age group 15–69 years, and from 23 to 47% in the age group 70–79 years. Conditional 5-year RS of patients who survived five years after diagnosis slightly improved as compared to unconditional 5-year RS at diagnosis. MM patients are two times more likely to die from non-myeloma malignancies (SMR = 1.97, 95% CI 1.81–2.15) and from cardiovascular diseases (SMR = 2.01, 95% CI 1.86–2.18) than the general population. Conclusions Prognosis of patients with MM has markedly improved since the year 2000 due to therapeutic advances. Nevertheless, late mortality remains a major concern. As survival improves, second primary malignancies and cardiovascular events deserve increased attention.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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

Eisfeld

Kajüter²,

Möller³

et al. 2023

BMC Cancer

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show abstract

“…In our analysis, MM patients were more likely to die from cardiovascular diseases or from non-myeloma malignancies (including SPM) compared to the general population. While in earlier studies the overall risk of SPM was not increased in MM patients [36], population-based studies have shown an increase in the incidence of SPM in recent years due to longer survival and possibly linked to the administration of lenalidomide and melphalan [12,37]. Consistent with our ndings, an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) Program found a proportion of non-myeloma cancer deaths in MM patients of 5.4% and showed a more than twofold increase in the risk of death from cardiovascular diseases in MM patients compared to the general population [11].…”

Section: Patient Characteristicsmentioning

confidence: 98%

“…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 lateoccurring side effects and cumulative toxicity might increase [10][11][12]. 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.…”

Section: Introductionmentioning

confidence: 99%

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

Eisfeld

Kajüter

Möller

et al. 2023

Preprint

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Background Steady evolution of therapies has improved prognosis of patients with multiple myeloma (MM) over the past two decades. Yet, knowledge about survival trends and causes of death in MM might play a crucial role in long-term management of this patient collective. Here, we investigate time trends in myeloma-specific survival at the population level over two decades and analyse causes of death in times of prolonged survival. Methods Age-standardised and age group-specific relative survival (RS) of MM patients aged <80 years at diagnosis was estimated for consecutive time periods from 2000-2019 using data from the Cancer Registry of North Rhine-Westphalia in Germany. Conditional RS was estimated for patients who already survived one to five years post diagnosis. Causes of death in MM patients were analysed and compared to the general population using standardised mortality ratios (SMR). Results Over two decades, age-standardised 5-year RS increased from 37% to 62%. Age-specific survival improved from 41% in period 2000-2004 to 69% in period 2015-2019 in the age group 15-69 years, and from 23% to 47% in the age group 70-79 years. Conditional 5-year RS of patients who survived five years after diagnosis slightly improved as compared to unconditional 5-year RS at diagnosis. MM patients are two times more likely to die from non-myeloma malignancies (SMR=1.97, 95% CI 1.81-2.15) and from cardiovascular diseases (SMR=2.01, 95% CI 1.86-2.18) than the general population. Conclusions Prognosis of patients with MM has markedly improved since the year 2000 due to therapeutic advances. Nevertheless, late mortality remains a major concern. As survival improves, second primary malignancies and cardiovascular events deserve increased attention.

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“…Although there is significant literature regarding the incidence of SPMs in MM, 1 there is a relative paucity of data regarding prognosis and mortality after SPM development. Available data on mortality after SPM development are either from European countries that lack the racial-ethnic diversity of the U.S., 2,3 are from retrospective single center studies, or do not include the modern era of anti-cancer therapeutics or International Myeloma Working Group (IMWG) imaging modalities. 4 Therefore, critical prognostic information on SPMs in MM patients within the U.S. in the modern era is not available.…”

mentioning

confidence: 99%

Prognostic impact of second primary malignancies in multiple myeloma: An ASCO CancerLinQ discovery analysis of the modern era

Gibson,

Cooper,

Pham

et al. 2023

American J Hematol

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Multiple myeloma (MM) is the second most common hematologic malignancy diagnosed in adults in the United States (U.S.). Current reports suggest that approximately 5%-7% of all MM patients develop a second primary malignancy (SPM) at some point during their disease course. 1 As novel MM therapies translate into improved long-term outcomes, it is conceivable that extended survival will lead to more time to develop SPMs. Although there is significant literature regarding the incidence of SPMs in MM, 1 there is a relative paucity of data regarding prognosis and mortality after SPM development. Available data on mortality after SPM development are either from European countries that lack the racial-ethnic diversity of the U.S., 2,3 are from retrospective single center studies, or do not include the modern era of anti-cancer therapeutics or International Myeloma Working Group (IMWG) imaging modalities. 4 Therefore, critical prognostic information on SPMs in MM patients within the U.S. in the modern era is not available. The American Society of Clinical Oncology's (ASCO) CancerLinQ Discovery ® (CLQD) MM data set was utilized to determine outcomes of real-world MM patients in the U.S. who developed SPMs in the modern treatment era. CancerLinQ ® is a health technology platform developed and implemented by ASCO that provides comprehensive real-world individual patient-level data from a diverse group of practice settings within the U.S. Aggregated, de-identified patient data from the CLQD MM data set were included for patients diagnosed with MM (ICD-9 and -10 codes 203.0 and C90.0, respectively) between 2009 and 2021. SPMs were considered any malignancy diagnosed

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Increased mortality risk in multiple-myeloma patients with subsequent malignancies: a population-based study in the Netherlands

Cited by 8 publications

References 15 publications

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

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

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

Prognostic impact of second primary malignancies in multiple myeloma: An ASCO CancerLinQ discovery analysis of the modern era

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