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Biol Blood Marrow Transplant. 2015 Apr;21(4):738-45. doi: 10.1016/j.bbmt.2014.12.028. Epub 2014 Dec 31.

New cancers after autotransplantations for multiple myeloma.

Author information

1
University of California San Francisco, California.
2
Jefferson Regional Medical Center, Pine Bluff, Arkansas.
3
University of Arkansas for Medical Sciences, Little Rock, Arkansas; Central Arkansas Veterans Healthcare System, Little Rock, Arkansas.
4
Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin.
5
Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
6
University Hospitals Bristol NHS Trust, Bristol, United Kingdom.
7
South Texas Veterans Health Care System and University of Texas Health Science Center San Antonio, San Antonio, Texas.
8
All Children's Hospital, St. Petersburg, Florida.
9
James Brown Cancer Center, University of Louisville Hospital, Louisville, Kentucky.
10
Fred Hutchinson Cancer Research Center, Seattle, Washington.
11
Baylor College of Medicine Center for Cell and Gene Therapy, Houston, Texas.
12
Mayo Clinic Rochester, Rochester, Minnesota.
13
Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio.
14
Cleveland Clinic, Cleveland, Ohio.
15
Shands HealthCare and University of Florida, Gainesville, Florida.
16
Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
17
Vanderbilt University Medical Center, Nashville, Tennessee.
18
UCLA Center for Health Sciences, Los Angeles, California.
19
University of Ottawa, Ottawa, Ontario, Canada.
20
Abramson Cancer Center University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.
21
Winship Cancer Institute, Emory University Hospital, Atlanta, Georgia.
22
Our Lady of Mercy Medical Center, Bronx, New York.
23
Stony Brook University Medical Center, Stony Brook, New York.
24
City of Hope National Medical Center, Duarte, California.
25
Celgene Corporation, Summit, New Jersey.
26
Imperial College, London, United Kingdom.
27
Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: phari@mcw.edu.

Abstract

We describe baseline incidence and risk factors for new cancers in 4161 persons receiving autotransplants for multiple myeloma in the United States from 1990 to 2010. Observed incidence of invasive new cancers was compared with expected incidence relative to the US population. The cohort represented 13,387 person-years at-risk. In total, 163 new cancers were observed, for a crude incidence rate of 1.2 new cancers per 100 person-years and cumulative incidences of 2.6% (95% confidence interval [CI], 2.09 to 3.17), 4.2% (95% CI, 3.49 to 5.00), and 6.1% (95% CI, 5.08 to 7.24) at 3, 5, and 7 years, respectively. The incidence of new cancers in the autotransplantation cohort was similar to age-, race-, and gender-adjusted comparison subjects with an observed/expected (O/E) ratio of 1.00 (99% CI, .81 to 1.22). However, acute myeloid leukemia and melanoma were observed at higher than expected rates with O/E ratios of 5.19 (99% CI, 1.67 to 12.04; P = .0004), and 3.58 (99% CI, 1.82 to 6.29; P < .0001), respectively. Obesity, older age, and male gender were associated with increased risks of new cancers in multivariate analyses. This large data set provides a baseline for comparison and defines the histologic type specific risk for new cancers in patients with MM receiving postautotransplantation therapies, such as maintenance.

KEYWORDS:

Myeloma; Second cancer; Transplantation

PMID:
25555448
PMCID:
PMC4359647
DOI:
10.1016/j.bbmt.2014.12.028
[Indexed for MEDLINE]
Free PMC Article

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