The impact of prior malignancies on second malignancies and survival in MM patients: a population-based study

• Published in: Blood Advances
• Main Authors: Jonsdottir, Gudbjörg, Lund, Sigrún H., Björkholm, Magnus, Turesson, Ingemar, Hultcrantz, Malin, Porwit, Anna, Jethava, Yogesh S., Landgren, Ola, Kristinsson, Sigurdur Y.
• Other Authors: 1 Univ Iceland, Fac Med, Saemundargata 2, IS-101 Reykjavik, Iceland Show more 2 Univ Iowa Hosp & Clin, Dept Internal Med, Iowa City, IA 52242 USA Show more 3 Karolinska Univ Hosp, Dept Med, Div Hematol, Stockholm, Sweden Show more 4 Karolinska Inst, Stockholm, Sweden Show more 5 Skane Univ Hosp, Dept Hematol, Malmo, Sweden Show more 6 Mem Sloan Kettering Canc Ctr, Myeloma Serv, 1275 York Ave, New York, NY 10021 USA Show more 7 Lund Univ, Div Oncol & Pathol, Dept Clin Sci, Fac Med, Lund, Sweden Show more 8 Univ Iowa Hosp & Clin, Dept Internal Med, Div Hematol Oncol Blood & Marrow Transplantat, Iowa City, IA 52242 USA
• Format: Article in Journal/Newspaper
• Language: English
• Published: American Society of Hematology 2018
• Subjects: Mergæxli; Beinmergur; Krabbamein; Lífslíkur; HEM12; Multiple Myeloma; Survival; Iceland
• Online Access: http://hdl.handle.net/2336/620507; https://doi.org/10.1182/bloodadvances.2017007930

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files In the present study, we aimed to evaluate 2 hypotheses. First, we hypothesize that prior malignancy is a proxy for genetic susceptibility that could be a risk factor for subsequent malignancy development in multiple myeloma (MM) patients. Second, we hypothesize that survival after MM is influenced by a prior malignancy. All patients diagnosed with MM from 1 January 1973 to 31 December 2010 were identified from the Swedish Cancer Register. Cox regression model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) where prior malignancy was compared in MM patients who developed a subsequent malignancy and MM patients who did not. In another Cox regression model, survival was compared in MM patients with and without a prior malignancy diagnosis. A total of 19 791 patients were diagnosed with MM. Patients with a prior malignancy diagnosis had a significantly increased risk of developing a subsequent malignancy compared with MM patients without (HR 1.42, 95% CI 1.23-1.65, P < .001). MM patients with a prior malignancy diagnosis had a significant 1.21-fold increased risk of death (95% CI 1.115-1.26, P < .001) compared with MM patients without. MM patients with 2 or more prior malignancy diagnoses had a 1.34-fold increased risk of death (95% CI 1.19-1.52, P < .001). In this large population-based study, we report that prior malignancy increases the risk of subsequent malignancy development in MM patients. Furthermore, we found that prior malignancy negatively impacts survival and that >1 prior malignancy reduces survival even further. Asrun Einarsdottir Foundation in Iceland Blodcancerfonden Swedish Cancer Society Stockholm County Council Karolinska Institutet Foundation University of Iceland Research Fund Icelandic Centre for Research Landspitali University Hospital Research Fund Marie Curie Career ...