[Impacts of new agents for multiple myeloma on development of secondary myelodysplastic syndrome and acute myeloid leukemia]

Rinsho Ketsueki. 2014 Apr;55(4):428-35.
[Article in Japanese]

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

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Boronic Acids / adverse effects*
  • Bortezomib
  • Chromosome Aberrations
  • Female
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects*
  • Lenalidomide
  • Leukemia, Myeloid, Acute / chemically induced*
  • Leukemia, Myeloid, Acute / epidemiology
  • Leukemia, Myeloid, Acute / genetics
  • Male
  • Melphalan / administration & dosage
  • Melphalan / adverse effects*
  • Middle Aged
  • Multiple Myeloma / drug therapy*
  • Myelodysplastic Syndromes / chemically induced*
  • Myelodysplastic Syndromes / epidemiology
  • Myelodysplastic Syndromes / genetics
  • Neoplasms, Second Primary / chemically induced*
  • Neoplasms, Second Primary / epidemiology
  • Neoplasms, Second Primary / genetics
  • Pyrazines / adverse effects*
  • Retrospective Studies
  • Thalidomide / administration & dosage
  • Thalidomide / adverse effects*
  • Thalidomide / analogs & derivatives*
  • Time Factors

Substances

  • Antineoplastic Agents
  • Boronic Acids
  • Immunosuppressive Agents
  • Pyrazines
  • Thalidomide
  • Bortezomib
  • Lenalidomide
  • Melphalan