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

作者: Ola Landgren , Sigurdur Y Kristinsson , Sigurdur Y Kristinsson , Ingemar Turesson , Gudbjorg Jonsdottir

DOI: 10.1111/EJH.13650

关键词: OncologyMyeloid leukemiaMelphalanMyelodysplastic syndromesMultiple myelomaRadiation therapyPopulationChemotherapyInternal medicineAnemiaMedicine

摘要: OBJECTIVES The aim of this study was to determine risk factors for development acute myeloid leukemia/myelodysplastic syndromes (AML/MDS) in patients with multiple myeloma (MM). METHODS We identified all diagnosed MM Sweden from January 1st, 1958 December 31, 2011. A total 26 627 were during the period. Of these, 124 (0.5%) developed subsequent AML/MDS. For each patient and a AML/MDS diagnosis, we randomly selected matched (age, sex, date diagnosis) without second malignancy diagnosis. RESULTS cumulative melphalan exposure significantly higher (OR = 2.8, 95% CI 1.7-5.2; P < .001) among cases (median 988 mg; IQR 644-1640) compared controls 578 mg; 360-967). Median time 3.8 years (IQR 2.8-5.8). Risk not statistically altered by M protein isotype, anemia, renal failure, hypercalcemia, lytic bone lesions, or radiation therapy. CONCLUSION In nationwide population-based study, show that increased doses alkylating therapy increases developing MM. Given improved survival over last decade future studies will be important better define long-term risks.

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