Grudeva-Popova J, Nenova I, Spasova M, Yaneva M, Beleva E, Ananoshtev N
Department of Oncology and Hematology, University Multiprofile Hospital for Active Treatment "Sv. Georgi", Plovdiv, Bulgaria.
J BUON. 2013 Apr-Jun;18(2):448-52.
To look at the frequency of second primary malignancies (SECMAL) in patients with multiple myeloma (MM).
The medical files of 332 patients with MM (whole group), diagnosed and treated at the University Multiprofile Hospital for Active Treatment "Sv. Georgi" and the Comprehensive Oncology Hospital (Plovdiv) for a 20-year period (1990-2010) were retrospectively analyzed. MM patients with SECMAL constituted the study group. A control group comprised patients with solid tumors associated with SECMAL. This group derived from a sample of 21768 patients with solid tumors.
In the study group, SECMAL was diagnosed in 4.52% (N=15) of the patients, while in the control group this figure was 5.09% (N=1108) (p>0.05). The diagnosis of MM preceded the occurrence of SECMAL in 35.71% of the study group patients, the median interval being 6.6 years (range 5-14). More frequently the diagnosis of the solid tumor preceded the occurrence of MM (66.67%). Breast cancer and gastric cancer were encountered with the highest frequency (26.67% each). The median survival (77.2 months, range 44-129) was significantly longer in the group with MM and SECMAL compared to the whole group with MM (median 38.6 months, range 10-58; p<0.05).
The rate of MM with other malignant diseases is comparable with the frequency of SECMAL in other lymphoproliferative disorders and solid tumors. The occurrence of SECMAL during the clinical course of MM is not a frequent event and is expected in the rare cases with longer survival.
研究多发性骨髓瘤(MM)患者中第二原发性恶性肿瘤(SECMAL)的发生率。
回顾性分析在“圣乔治”大学综合积极治疗医院和普罗夫迪夫综合肿瘤医院诊断并治疗的332例MM患者(全组)20年期间(1990 - 2010年)的病历。患有SECMAL的MM患者构成研究组。对照组包括与SECMAL相关的实体瘤患者。该组来自21768例实体瘤患者的样本。
在研究组中,4.52%(N = 15)的患者被诊断为SECMAL,而在对照组中这一数字为5.09%(N = 1108)(p>0.05)。在研究组35.71%的患者中,MM的诊断先于SECMAL的发生,中位间隔时间为6.6年(范围5 - 14年)。实体瘤的诊断更常先于MM的发生(66.67%)。乳腺癌和胃癌的发生率最高(各为26.67%)。与整个MM组(中位生存期38.6个月,范围10 - 58个月;p<0.05)相比,伴有SECMAL的MM组中位生存期显著更长(77.2个月,范围44 - 129个月)。
MM合并其他恶性疾病的发生率与其他淋巴增生性疾病和实体瘤中SECMAL的发生率相当。MM临床过程中SECMAL的发生并不常见,预计仅在少数生存期较长的病例中出现。