Abstract
The use of new agents (NAs) such as bortezomib, thalidomide, and lenalidomide has extended the survival of patients with multiple myeloma (MM). However, whether long-term treatment using NAs may increase the risk of second primary malignancies is a concern. Three hundred and thirty-three patients with MM were treated at our hospital from 1998 to 2013. Additional chromosomal abnormalities (CAs), associated with secondary myelodysplastic syndrome/acute myeloid leukemia, were observed in 13 of 152 users of NAs, but in 38 of 181 non-users of NAs. The cumulative CA incidence was higher in non-users of NAs. The CAs frequently observed were 13q-, 20q-, +8 in users of NAs, while -5/5q- and -7/7q- were detected in non-users of NAs. The total dose and treatment period of NAs did not differ between CAs-positive and -negative patients. However, a higher dose of melphalan was observed to have been used in patients who had CAs. Longer follow-up periods are necessary for an accurate risk assessment.
MeSH terms
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Adult
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Aged
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Aged, 80 and over
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Antineoplastic Agents / administration & dosage
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Antineoplastic Agents / adverse effects*
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Boronic Acids / adverse effects*
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Bortezomib
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Chromosome Aberrations
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Female
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Humans
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Immunosuppressive Agents / administration & dosage
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Immunosuppressive Agents / adverse effects*
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Lenalidomide
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Leukemia, Myeloid, Acute / chemically induced*
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Leukemia, Myeloid, Acute / epidemiology
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Leukemia, Myeloid, Acute / genetics
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Male
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Melphalan / administration & dosage
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Melphalan / adverse effects*
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Middle Aged
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Multiple Myeloma / drug therapy*
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Myelodysplastic Syndromes / chemically induced*
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Myelodysplastic Syndromes / epidemiology
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Myelodysplastic Syndromes / genetics
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Neoplasms, Second Primary / chemically induced*
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Neoplasms, Second Primary / epidemiology
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Neoplasms, Second Primary / genetics
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Pyrazines / adverse effects*
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Retrospective Studies
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Thalidomide / administration & dosage
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Thalidomide / adverse effects*
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Thalidomide / analogs & derivatives*
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Time Factors
Substances
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Antineoplastic Agents
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Boronic Acids
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Immunosuppressive Agents
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Pyrazines
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Thalidomide
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Bortezomib
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Lenalidomide
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Melphalan