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Second malignancies after multiple myeloma: from 1960s to 2010s.

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Authors
Thomas, Anish
Mailankody, Sham
Korde, Neha
Kristinsson, Sigurdur Y
Turesson, Ingemar
Landgren, Ola
Issue Date
2012-03-22

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Citation
Blood 2012, 119(12):2731-7
Abstract
Based on small numbers, recent reports from 3 randomized trials have consistently demonstrated more hematologic malignancies in patients treated with lenalidomide as maintenance (vs placebo). This fact has prompted concern and highlighted the association between multiple myeloma and second malignancies. Furthermore, an excess of acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) after multiple myeloma has been known for over 4 decades. Most prior studies have been restricted because of small numbers of patients, inadequate follow-up, and limitations of ascertainment of second malignancies. Although the underlying biologic mechanisms of AML/MDS after multiple myeloma are unknown, treatment-related factors are presumed to be responsible. Recently, an excess risk of AML/MDS was found among 5652 patients with IgG/IgA (but not IgM) monoclonal gammopathy of undetermined significance, supporting a role for disease-related factors. Furthermore, there is evidence to suggest that polymorphisms in germline genes may contribute to a person's susceptibility to subsequent cancers, whereas the potential influence of environmental and behavioral factors remains poorly understood. This review discusses current knowledge regarding second malignancies after multiple myeloma and gives future directions for efforts designed to characterize underlying biologic mechanisms, with the goal to maximize survival and minimize the risk for second malignancies for individual patients.
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http://dx.doi.org/10.1182/blood-2011-12-381426
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3327452/
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Archived with thanks to Blood
ae974a485f413a2113503eed53cd6c53
10.1182/blood-2011-12-381426
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English Journal Articles (Peer Reviewed)

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