Secondary primary malignancies in patients with multiple myeloma treated with high‐dose chemotherapy and autologous blood stem cell transplantation

Fenk, Roland; Neubauer, F; Bruns, Ingmar; Schröder, T.; Germing, Ulrich; Haas, Rainer; Kobbe, Guido

doi:10.1111/j.1365-2141.2011.08905.x

Cited by 19 publications

(19 citation statements)

References 7 publications

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“…4,[6][7][8]13,17 Other reports of second cancer rates after autologous HCT have not statistically compared the observed cancer rates with those of the general population. 10,11,18,19 Compared with the general population, we found an elevated second cancer risk in males, young adults and the earlier transplant eras. The high numbers of males transplanted for HL, NHL and testicular cancer may have influenced this finding to some extent, as these indications also had an increased second cancer risk.…”

Section: Discussionmentioning

confidence: 55%

Second cancer risk in adults receiving autologous haematopoietic SCT for cancer: a population-based cohort study

Marsney

Daniels

Ashton

et al. 2014

Bone Marrow Transplant

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, CM Vajdic 5 and CAST study group 6 Population-based evidence on second cancer risk following autologous haematopoietic SCT (HCT) is lacking. We quantified second cancer risk for a national, population-based cohort of adult Australians receiving autologous HCT for cancer and notified to the Australasian Bone Marrow Transplant Recipient Registry 1992Registry -2007. Cancer diagnoses and deaths were ascertained by linkage with the Australian Cancer Database and National Death Index. Standardized incidence ratios (SIRs) were calculated and Cox regression models were used to estimate within-cohort risk factors treating death as a competing risk. During a median 2.5 years follow-up, second cancer risk was modestly increased compared with the general population (SIR 1.4, 95% confidence interval 1.2-1.6); significantly elevated risk was also observed for AML/myelodysplastic syndrome (SIR ¼ 20.6), melanoma (SIR ¼ 2.6) and non-Hodgkin lymphoma (SIR ¼ 3.3). Recipients at elevated risk of any second cancer included males, and those transplanted at a younger age, in an earlier HCT era, or for lymphoma or testicular cancer. Male sex, older age (445 years) and history of relapse after HCT predicted melanoma risk. Transplantation for Hodgkin lymphoma and older age were associated with lung cancer risk. Second malignancies are an important late effect and these results inform and emphasize the need for cancer surveillance in autologous HCT survivors.Bone Marrow Transplantation (2014) 49, 691-698; doi:10.1038/bmt.2014.13; published online 17 February 2014Keywords: autologous transplantation; outcomes; risk; surveillance INTRODUCTION Autologous haematopoietic SCT (HCT) is increasingly being used in Australia and elsewhere as a therapy for several haematopoietic and solid organ malignancies. 1,2 Life expectancy following HCT has also improved, 3 increasing the number of HCT survivors globally. Characterizing late effects and identifying those at risk will maximize the long-term health of HCT recipients.Second cancers are a recognized late effect of chemo-radiation therapy in general, and in the HCT setting specifically. 4-11 The cumulative incidence of second cancer after autologous HCT may be as high as 29% after 15 years, 11 with the greatest excess risk observed for AML and myelodysplastic syndromes (MDSs). 10,[12][13][14][15] Most prior studies have examined second cancer risk in recipients of allogeneic and autologous HCT, with the largest based on international transplant registry cohorts. 9 Furthermore, most studies ascertained second cancers from hospital records or by self-report, potentially under-estimating risk. There are no population-based estimates of the risk of secondary cancer in adult recipients of autologous HCT. We examined the incidence and risk factors for second cancer in a national, population-based cohort of 7765 adult Australian autologous HCT recipients, 1992HCT recipients, -2007

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Section: Discussionmentioning

confidence: 55%

Second cancer risk in adults receiving autologous haematopoietic SCT for cancer: a population-based cohort study

Marsney

Daniels

Ashton

et al. 2014

Bone Marrow Transplant

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“…In a review article which evaluates 5 decades, an incidence between 1.1 and 12.2% was reported [17], with most studies not mentioning a cumulative risk or the prognostic impact of having or developing an SMN. In two transplant studies that included younger patients without serious comorbidities, a cumulative incidence of 15.7% SMN after 10 years (from first diagnosis) [45] and 11.2% from the date of transplant [46] were reported. In the previously cited single-center study which included transplant and nontransplant patients and followed patients over more than 10 years, a cumulative SMN incidence of 11.6% at 10 years was estimated [40].…”

Section: Discussionmentioning

confidence: 99%

The Shreveport Myeloma Experience: Survival, Risk Factors and Other Malignancies in the Age of Stem Cell Transplantation

Munker¹,

Shi²,

Nair³

et al. 2015

Acta Haematol

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Background: The overall prognosis of multiple myeloma has improved significantly over the last 15 years. We wondered whether the overall improvement would also be seen in unselected patients in an academic center in Northwest Louisiana with a high proportion of minority patients, and if second malignant neoplasms are relevant for our patients. Materials and Methods: Between 1998 and 2009, 215 patients were treated for multiple myeloma at our center and had complete follow-up until May 2013. Results: The mean survival of patients with multiple myeloma increased from 3.25 to 5.34 years, which is comparable to patients treated at larger centers. No prognostic difference was observed in the subgroups of myeloma patients. Among 215 patients followed for the development of secondary cancers, 16 already had a preexisting or concomitant malignancy (7.4%) and 10 developed secondary cancers. Our data indicate a significant background of histologically unrelated cancers and a cumulative incidence of new cancers of about 20% after 10 years of follow-up. Based on SEER data, preexisting or secondary cancers were not statistically increased in our population. Conclusions: The use of autologous transplantation and the introduction of new agents resulted in a significant improvement in the prognosis of multiple myeloma. Other cancers are not statistically increased before or after multiple myeloma is diagnosed and are not prognostically relevant.

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“…Myelomás betegeink 4,1%-ában fordult elő carcinoma, ami csak kissé marad el az irodalom alapján várhatótól [20,21]. A társulások nagy többségében megyénkben is a carcinoma volt az elsődleges malignitás, a myelomát évekkel később diagnosztizáltuk [21].…”

Section: Megbeszélésunclassified

“…Egyes előrejelzések szerint a betegek várhatóan jelentősen megnövekvő élettartama a myelomát követő szekunder carcinomák gyakoriságának a fokozódásához fog vezetni, ugyanakkor az alkalmazott kemoterápiás szerek gyakoriságot fokozó hatása sem hanyagolható el [20,[22][23][24].…”

Section: Megbeszélésunclassified

A myeloma epidemiológiai jellemzői Szabolcs-Szatmár-Bereg megyében. 33 év adatainak elemzése

Jakó

Szerafin

2016

Orvosi Hetilap

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Bevezetés: A szerzők 30 év tapasztalatait ismertető közleménye óta nem jelent meg tanulmány a malignus hematoló-giai betegségek hazai incidenciájáról. Célkitűzés: A myelomára vonatkozó megyei epidemiológiai adatok részletes elemzése. Módszer: A szerzők a Szabolcs-Szatmár-Bereg megyei leukaemia/lymphoma regiszterben 33 év alatt (1983. január 1. és 2015. december 31. között) 4521 újonnan felismert, malignus hematológiai megbetegedésben szenvedő, megyéjükben élő felnőtt beteg adatait rögzítették. A 4521 beteg között 440 myelomás (397 myeloma multiplex, 38 lokális, csont-, lágyrész-plasmocytoma és 5 primer plazmasejtes leukaemia) fordult elő, a regisztráltak 9,73%-a. Eredmények: A myeloma megyei incidenciája emelkedő tendenciát mutat, a teljes vizsgált időszakra vonatkozóan 2,33/100 000 lakos/év. A férfi:nő arány 45,9%:54,1%, a betegek átlagéletkora 65,1 (28-90) év. A myeloma multiplexes betegek 59,4%-ában monoklonális IgG-immunglobulin volt jelen. A megyében egyetlen olyan település sem volt, ahol a megyei átlaghoz (0,78) viszonyítva statisztikailag szignifikánsan nagyobb volt az ezer lakosra jutó myelomás betegek száma. Következtetések: Az ismertetett epidemiológiai sajátosságok -az enyhe női dominanciától eltekintve -lényegében megfelelnek az irodalmi adatoknak. Orv. Hetil., 2016, 157(34), 1357-1360.Kulcsszavak: malignus hematológiai kórképek, myeloma, incidencia, életkor és nemek szerinti megoszlás, területi eloszlás, familiaritás, myeloma és carcinoma társulása, Szabolcs-Szatmár-Bereg megye

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Secondary primary malignancies in patients with multiple myeloma treated with high‐dose chemotherapy and autologous blood stem cell transplantation

Cited by 19 publications

References 7 publications

Second cancer risk in adults receiving autologous haematopoietic SCT for cancer: a population-based cohort study

Second cancer risk in adults receiving autologous haematopoietic SCT for cancer: a population-based cohort study

The Shreveport Myeloma Experience: Survival, Risk Factors and Other Malignancies in the Age of Stem Cell Transplantation

A myeloma epidemiológiai jellemzői Szabolcs-Szatmár-Bereg megyében. 33 év adatainak elemzése

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