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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    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 languageEnglish
    Article number4359
    Pages (from-to)1-14
    Number of pages14
    Issue number17
    Early online date1 Sept 2023
    Publication statusPublished online - 1 Sept 2023

    Bibliographical note

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    © 2023 by the authors.


    • second primary malignancy
    • SPM
    • multiple myeloma
    • therapy


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