Cumulative exposure to melphalan chemotherapy and subsequent risk of developing acute myeloid leukemia and myelodysplastic syndromes in patients with multiple myeloma Journal Article

   

Authors:	Jonsdottir, G.; Björkholm, M.; Turesson, I.; Hultcrantz, M.; Diamond, B.; Porwit, A.; Landgren, O.; Kristinsson, S. Y.
Article Title:	Cumulative exposure to melphalan chemotherapy and subsequent risk of developing acute myeloid leukemia and myelodysplastic syndromes in patients with multiple myeloma
Abstract:	Objectives: The aim of this study was to determine risk factors for development of acute myeloid leukemia/myelodysplastic syndromes (AML/MDS) in patients with multiple myeloma (MM). Methods: We identified all patients diagnosed with MM in Sweden from January 1st, 1958 to December 31, 2011. A total of 26 627 patients were diagnosed with MM with during the study period. Of these, 124 patients (0.5%) developed subsequent AML/MDS. For each patient with MM and a subsequent AML/MDS diagnosis, we randomly selected a matched (age, sex, and date of MM diagnosis) MM patient without a subsequent second malignancy diagnosis. Results: The cumulative melphalan exposure was significantly higher (OR = 2.8, 95% CI 1.7-5.2; P <.001) among cases (median 988 mg; IQR 644-1640) compared with controls (median 578 mg; IQR 360-967). Median time to AML/MDS development was 3.8 years (IQR 2.8-5.8). Risk of AML/MDS was not statistically altered by M protein isotype, anemia, renal failure, hypercalcemia, lytic bone lesions, or radiation therapy. Conclusion: In this nationwide population-based study, we show that increased cumulative doses of alkylating therapy with melphalan increases the subsequent risk of developing AML/MDS in patients with MM. Given improved survival in MM patients over the last decade future studies will be important to better define long-term risks. © 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Keywords:	multiple myeloma; melphalan; second malignancies; acute myeloid leukemia/myelodysplastic syndromes; alkylating therapy
Journal Title:	European Journal of Haematology
Volume:	107
Issue:	2
ISSN:	0902-4441
Publisher:	John Wiley & Sons
Date Published:	2021-08-01
Start Page:	275
End Page:	282
Language:	English
DOI:	10.1111/ejh.13650
PUBMED:	33966293
PROVIDER:	scopus
PMCID:	PMC11036135
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85106755597&doi=10.1111%2fejh.13650&partnerID=40&md5=d0a59d00830e4792533901f953dfa339
Notes:	Article -- Export Date: 2 August 2021 -- Source: Scopus

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