Effect of autologous hematopoietic stem cell transplant on the development of second primary malignancies in multiple myeloma patients

Autologous stem cell transplant (aHSCT) is associated with improved survival for multiple myeloma (MM) patients but may be associated with second primary malignancy (SPM) development. Using the California Cancer Registry linked to statewide hospitalization data, we determined the cumulative incidenc...

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Bibliographic Details
Published in:Blood cancer journal (New York) 2021-01, Vol.11 (1), p.5-5, Article 5
Main Authors: Rosenberg, A. S., Brunson, A., Tuscano, J., Jonas, B. A., Hoeg, R., Wun, T., Keegan, T. H. M.
Format: Article
Language:English
Subjects:
631/67/2195
692/499
692/699/67/1990/804
Biomedical and Life Sciences
Biomedicine
Cancer Research
Cancer therapies
Chemotherapy
Ethnicity
Hematology
Leukemia
Mortality
Multiple myeloma
Neighborhoods
Oncology
Patients
Population
Socioeconomic factors
Stem cell transplantation
Stem cells
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Summary:Autologous stem cell transplant (aHSCT) is associated with improved survival for multiple myeloma (MM) patients but may be associated with second primary malignancy (SPM) development. Using the California Cancer Registry linked to statewide hospitalization data, we determined the cumulative incidence (CMI) of SPMs more than 1 year after MM diagnosis, accounting for the competing risk of death. AHSCT recipients were matched 1:2 to non-aHSCT patients. Adjusted hazard ratios (aHR) were estimated using the Fine and Gray method. Among 16,331 patients, 933 (5.7%) developed a SPM more than 1 year after diagnosis. The 10-year CMI of developing any SPM was 6.6%, 5.7% for solid tumor SPM and 0.9% for hematologic malignancies. The 10-year CMI of developing any SPM was similar among aHSCT [9.1% (7.7–10.7%)] and non-aHSCT [7.5% (6.5–8.6%)] ( P  = 0.26) recipients and there was no difference in solid-tumor SPMs ( P  = 0.98). The 10-year CMI of hematologic SPMs was higher among aHSCT recipients [2.1% (1.4–2.9%) vs. 0.8% (0.5–1.2%); P  = 0.005], corresponding to a 1.3% absolute increase and an aHR of 1.51 (1.01–2.27). Ten-year myeloma-specific and non-cancer mortality rates were 59% (58.2–60.0%) and 18.1% (17.4–18.8%), respectively. Although aHSCT was associated with a small increase in hematologic SPMs, mortality was driven by MM and non-cancer causes.
ISSN:2044-5385
2044-5385
DOI:10.1038/s41408-020-00400-4