Outcome of Second Primary Malignancies Developing in Multiple Myeloma Patients

Irit Avivi; David H. Vesole; Julio Davila-Valls; Lidia Usnarska-Zubkiewicz; Magdalena Olszewska-Szopa; Vibor Milunovic; Bartłomiej Baumert; Bogumiła Osękowska; Anna Kopińska; Massimo Gentile; Borja Puertas-Martinez; Paweł Robak; Edvan Crusoe; Luis Gerardo Rodriguez-Lobato; Małgorzata Gajewska; Gergely Varga; Michel Delforge; Yael Cohen; Alessandro Gozzetti; Camila Pena; Chaim Shustik; Gabor Mikala; Klara Zalac; H. Denis Alexander; Peter Barth; Katja Weisel; Joaquín Martínez-López; Anna Waszczuk-Gajda; Mateusz Krzystański; Artur Jurczyszyn

doi:10.3390/cancers15174359

Outcome of Second Primary Malignancies Developing in Multiple Myeloma Patients

Irit Avivi, David H. Vesole, Julio Davila-Valls, Lidia Usnarska-Zubkiewicz, Magdalena Olszewska-Szopa, Vibor Milunovic, Bartłomiej Baumert, Bogumiła Osękowska, Anna Kopińska, Massimo Gentile, Borja Puertas-Martinez, Paweł Robak, Edvan Crusoe, Luis Gerardo Rodriguez-Lobato, Małgorzata Gajewska, Gergely Varga, Michel Delforge, Yael Cohen, Alessandro Gozzetti, Camila PenaChaim Shustik, Gabor Mikala, Klara Zalac, H. Denis Alexander, Peter Barth, Katja Weisel, Joaquín Martínez-López, Anna Waszczuk-Gajda, Mateusz Krzystański, Artur Jurczyszyn

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Abstract

Background: There is an increased risk of second primary malignancies (SMPs) in patients with multiple myeloma (MM). This multinational ‘real-world’ retrospective study analyzed the characteristics and outcomes of MM patients that developed SPMs. Results: 165 patients were analyzed: 62.4% males; 8.5% with a prior cancer; 113 with solid SPMs, mainly ≥stage 2; and 52 with hematological SPM (hemato-SPM), mainly MDS/AML. Patients with hemato-SPM were younger (p = 0.05) and more frequently had a prior AutoHCT (p = 0.012). The time to SPM was shorter in the older (>65 years) and more heavily pretreated patients. One hundred patients were actively treated at the time of SPM detection. Treatment was discontinued in 52, substituted with another anti-MM therapy in 15, and continued in 33 patients. Treatment discontinuation was predominant in the patients diagnosed with hemato-SPM (76%). The median OS following SPM detection was 8.5 months, and the main cause of death was SPM. A poor ECOG status predicted a shorter OS (PS 3 vs. 0, HR = 5.74, 2.32–14.21, p < 0.001), whereas a normal hemoglobin level (HR = 0.43, 0.19–0.95, p = 0.037) predicted longer OS. Conclusions: With the continuing improvement in OS, a higher proportion of MM patients might develop SPM. The OS following SPM diagnosis is poor; hence, frequent surveillance and early detection are imperative to improve outcomes.

Original language	English
Article number	4359
Pages (from-to)	1-14
Number of pages	14
Journal	Cancers
Volume	15
Issue number	17
Early online date	1 Sept 2023
DOIs	https://doi.org/10.3390/cancers15174359
Publication status	Published online - 1 Sept 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Keywords

second primary malignancy
SPM
multiple myeloma
therapy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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cancers-15-04359-v2Final published version, 1.14 MBLicence: CC BY

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Avivi, I., Vesole, D. H., Davila-Valls, J., Usnarska-Zubkiewicz, L., Olszewska-Szopa, M., Milunovic, V., Baumert, B., Osękowska, B., Kopińska, A., Gentile, M., Puertas-Martinez, B., Robak, P., Crusoe, E., Rodriguez-Lobato, L. G., Gajewska, M., Varga, G., Delforge, M., Cohen, Y., Gozzetti, A., ... Jurczyszyn, A. (2023). Outcome of Second Primary Malignancies Developing in Multiple Myeloma Patients. Cancers, 15(17), 1-14. Article 4359. Advance online publication. https://doi.org/10.3390/cancers15174359

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title = "Outcome of Second Primary Malignancies Developing in Multiple Myeloma Patients",

abstract = "Background: There is an increased risk of second primary malignancies (SMPs) in patients with multiple myeloma (MM). This multinational {\textquoteleft}real-world{\textquoteright} retrospective study analyzed the characteristics and outcomes of MM patients that developed SPMs. Results: 165 patients were analyzed: 62.4% males; 8.5% with a prior cancer; 113 with solid SPMs, mainly ≥stage 2; and 52 with hematological SPM (hemato-SPM), mainly MDS/AML. Patients with hemato-SPM were younger (p = 0.05) and more frequently had a prior AutoHCT (p = 0.012). The time to SPM was shorter in the older (>65 years) and more heavily pretreated patients. One hundred patients were actively treated at the time of SPM detection. Treatment was discontinued in 52, substituted with another anti-MM therapy in 15, and continued in 33 patients. Treatment discontinuation was predominant in the patients diagnosed with hemato-SPM (76%). The median OS following SPM detection was 8.5 months, and the main cause of death was SPM. A poor ECOG status predicted a shorter OS (PS 3 vs. 0, HR = 5.74, 2.32–14.21, p < 0.001), whereas a normal hemoglobin level (HR = 0.43, 0.19–0.95, p = 0.037) predicted longer OS. Conclusions: With the continuing improvement in OS, a higher proportion of MM patients might develop SPM. The OS following SPM diagnosis is poor; hence, frequent surveillance and early detection are imperative to improve outcomes.",

keywords = "second primary malignancy, SPM, multiple myeloma, therapy",

author = "Irit Avivi and Vesole, {David H.} and Julio Davila-Valls and Lidia Usnarska-Zubkiewicz and Magdalena Olszewska-Szopa and Vibor Milunovic and Bart{\l}omiej Baumert and Bogumi{\l}a Os{\c e}kowska and Anna Kopi{\'n}ska and Massimo Gentile and Borja Puertas-Martinez and Pawe{\l} Robak and Edvan Crusoe and Rodriguez-Lobato, {Luis Gerardo} and Ma{\l}gorzata Gajewska and Gergely Varga and Michel Delforge and Yael Cohen and Alessandro Gozzetti and Camila Pena and Chaim Shustik and Gabor Mikala and Klara Zalac and Alexander, {H. Denis} and Peter Barth and Katja Weisel and Joaqu{\'i}n Mart{\'i}nez-L{\'o}pez and Anna Waszczuk-Gajda and Mateusz Krzysta{\'n}ski and Artur Jurczyszyn",

note = "Publisher Copyright: {\textcopyright} 2023 by the authors.",

year = "2023",

month = sep,

day = "1",

doi = "10.3390/cancers15174359",

language = "English",

volume = "15",

pages = "1--14",

journal = "Cancers",

issn = "2072-6694",

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Avivi, I, Vesole, DH, Davila-Valls, J, Usnarska-Zubkiewicz, L, Olszewska-Szopa, M, Milunovic, V, Baumert, B, Osękowska, B, Kopińska, A, Gentile, M, Puertas-Martinez, B, Robak, P, Crusoe, E, Rodriguez-Lobato, LG, Gajewska, M, Varga, G, Delforge, M, Cohen, Y, Gozzetti, A, Pena, C, Shustik, C, Mikala, G, Zalac, K, Alexander, HD, Barth, P, Weisel, K, Martínez-López, J, Waszczuk-Gajda, A, Krzystański, M & Jurczyszyn, A 2023, 'Outcome of Second Primary Malignancies Developing in Multiple Myeloma Patients', Cancers, vol. 15, no. 17, 4359, pp. 1-14. https://doi.org/10.3390/cancers15174359

TY - JOUR

T1 - Outcome of Second Primary Malignancies Developing in Multiple Myeloma Patients

AU - Avivi, Irit

AU - Vesole, David H.

AU - Davila-Valls, Julio

AU - Usnarska-Zubkiewicz, Lidia

AU - Olszewska-Szopa, Magdalena

AU - Milunovic, Vibor

AU - Baumert, Bartłomiej

AU - Osękowska, Bogumiła

AU - Kopińska, Anna

AU - Gentile, Massimo

AU - Puertas-Martinez, Borja

AU - Robak, Paweł

AU - Crusoe, Edvan

AU - Rodriguez-Lobato, Luis Gerardo

AU - Gajewska, Małgorzata

AU - Varga, Gergely

AU - Delforge, Michel

AU - Cohen, Yael

AU - Gozzetti, Alessandro

AU - Pena, Camila

AU - Shustik, Chaim

AU - Mikala, Gabor

AU - Zalac, Klara

AU - Alexander, H. Denis

AU - Barth, Peter

AU - Weisel, Katja

AU - Martínez-López, Joaquín

AU - Waszczuk-Gajda, Anna

AU - Krzystański, Mateusz

AU - Jurczyszyn, Artur

PY - 2023/9/1

Y1 - 2023/9/1

N2 - Background: There is an increased risk of second primary malignancies (SMPs) in patients with multiple myeloma (MM). This multinational ‘real-world’ retrospective study analyzed the characteristics and outcomes of MM patients that developed SPMs. Results: 165 patients were analyzed: 62.4% males; 8.5% with a prior cancer; 113 with solid SPMs, mainly ≥stage 2; and 52 with hematological SPM (hemato-SPM), mainly MDS/AML. Patients with hemato-SPM were younger (p = 0.05) and more frequently had a prior AutoHCT (p = 0.012). The time to SPM was shorter in the older (>65 years) and more heavily pretreated patients. One hundred patients were actively treated at the time of SPM detection. Treatment was discontinued in 52, substituted with another anti-MM therapy in 15, and continued in 33 patients. Treatment discontinuation was predominant in the patients diagnosed with hemato-SPM (76%). The median OS following SPM detection was 8.5 months, and the main cause of death was SPM. A poor ECOG status predicted a shorter OS (PS 3 vs. 0, HR = 5.74, 2.32–14.21, p < 0.001), whereas a normal hemoglobin level (HR = 0.43, 0.19–0.95, p = 0.037) predicted longer OS. Conclusions: With the continuing improvement in OS, a higher proportion of MM patients might develop SPM. The OS following SPM diagnosis is poor; hence, frequent surveillance and early detection are imperative to improve outcomes.

AB - Background: There is an increased risk of second primary malignancies (SMPs) in patients with multiple myeloma (MM). This multinational ‘real-world’ retrospective study analyzed the characteristics and outcomes of MM patients that developed SPMs. Results: 165 patients were analyzed: 62.4% males; 8.5% with a prior cancer; 113 with solid SPMs, mainly ≥stage 2; and 52 with hematological SPM (hemato-SPM), mainly MDS/AML. Patients with hemato-SPM were younger (p = 0.05) and more frequently had a prior AutoHCT (p = 0.012). The time to SPM was shorter in the older (>65 years) and more heavily pretreated patients. One hundred patients were actively treated at the time of SPM detection. Treatment was discontinued in 52, substituted with another anti-MM therapy in 15, and continued in 33 patients. Treatment discontinuation was predominant in the patients diagnosed with hemato-SPM (76%). The median OS following SPM detection was 8.5 months, and the main cause of death was SPM. A poor ECOG status predicted a shorter OS (PS 3 vs. 0, HR = 5.74, 2.32–14.21, p < 0.001), whereas a normal hemoglobin level (HR = 0.43, 0.19–0.95, p = 0.037) predicted longer OS. Conclusions: With the continuing improvement in OS, a higher proportion of MM patients might develop SPM. The OS following SPM diagnosis is poor; hence, frequent surveillance and early detection are imperative to improve outcomes.

KW - second primary malignancy

KW - SPM

KW - multiple myeloma

KW - therapy

UR - http://www.scopus.com/inward/record.url?scp=85170380030&partnerID=8YFLogxK

U2 - 10.3390/cancers15174359

DO - 10.3390/cancers15174359

M3 - Article

C2 - 37686635

SN - 2072-6694

VL - 15

SP - 1

EP - 14

JO - Cancers

JF - Cancers

IS - 17

M1 - 4359

ER -

Outcome of Second Primary Malignancies Developing in Multiple Myeloma Patients

Abstract

Bibliographical note

Keywords

UN SDGs

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