What question did this study set out to answer?

This research aims to evaluate the risk of acute myeloid leukemia and myelodysplastic syndromes following multiple myeloma and its precursor disease, MGUS.

July 28, 2011Open Access

Risk of acute myeloid leukemia and myelodysplastic syndromes after multiple myeloma and its precursor disease (MGUS)

SMSham MailankodyMemorial Sloan Kettering Cancer Center RPRuth M. PfeifferDartmouth College SKSigurður Y. KristinssonReykjavík University

Key Points

This research aims to evaluate the risk of acute myeloid leukemia and myelodysplastic syndromes following multiple myeloma and its precursor disease, MGUS.
Analyzed data from a population-based registry in Sweden involving multiple myeloma and MGUS patients.
Calculated standardized incidence rates (SIRs) for hematologic malignancies.
Stratified data based on diagnosis year to assess risks before and after treatment changes.
MM patients showed an 11.51-fold increased risk for AML/MDS compared to the general population.
MGUS patients had an 8.01-fold increased risk for AML/MDS.
The highest risk of AML/MDS was observed in patients with M-protein concentrations greater than 1.5 g/dL.

Abstract

Using population-based data from Sweden, we identified all multiple myeloma (MM) patients (n = 8740) and 5652 monoclonal gammopathy of undetermined significance (MGUS) patients diagnosed between 1986 and 2005. We calculated standardized incidence rates (SIRs) for all subsequent hematologic and nonhematologic malignancies for MM patients diagnosed before/after 1995 (introduction of high-dose melphalan/autologous stem cell transplantation HDM-ASCT) and 2000 (introduction of immunomodulatory drugs IMiDs), respectively. MM patients had an 11.51-fold (95% confidence interval: 8.19-15.74) increased risk of acute myeloid leukemia (AML)/myelodysplastic syndromes (MDS); risk was very similar before/after 1995 and 2000, respectively. MGUS patients had an 8.01-fold (5.40-11.43) increased risk of AML/MDS. Risk was confined to IgG/IgA, while no IgM MGUS patients developed AML/MDS; patients with monoclonal-protein (M-protein) concentrations > 1.5 g/dL (SIR = 11.12; 3.61-25.96) had higher risk than those 1.5 g/dL, support a role for nontreatment-related factors in plasma cell dyscrasias. AML/MDS risk following MM was the same before/after the introduction of HDM-ASCT. Longer follow-up is needed to characterize second tumor risks in the IMiD era.

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