Munker Reinhold, Shi Runhua, Lin Derek, Guo Shan, Hayes Teresa G
Louisiana State University, Health Sciences Center, Shreveport, LA.
Louisiana State University, Health Sciences Center, Shreveport, LA.
Clin Lymphoma Myeloma Leuk. 2014 Apr;14(2):102-6. doi: 10.1016/j.clml.2013.10.006. Epub 2013 Nov 15.
The prognosis of multiple myeloma (MM) has improved in recent years. Therefore, second malignant neoplasms (SMNs) may become an issue for longer term survivors with MM. An increased incidence of second malignancies was reported in patients who received lenalidomide for relapsed or refractory myeloma.
Data from the Tumor Registry of the Michael E. DeBakey VA Medical Center (1995-2010) were analyzed. Kaplan-Meier survival statistics were calculated.
In 197 patients with MM, 39 different cancers were observed in 33 patients, the large majority occurring before the diagnosis of MM, with most being early-stage or good-prognosis malignancies. Despite this, the prognosis of patients with a second or third cancer was clearly inferior to patients without other cancers. Notable was a significant number of prostate cancers as preexisting malignancies.
At present, most other cancers (for which MM is the secondary malignancy) may not be related to the treatment for myeloma, but due to underlying immunologic, genetic, or environmental factors. Larger studies and careful follow-up, especially in good-risk patients treated with novel agents, are indicated.
近年来，多发性骨髓瘤（MM）的预后有所改善。因此，第二原发性恶性肿瘤（SMNs）可能成为MM长期存活者面临的一个问题。据报道，接受来那度胺治疗复发或难治性骨髓瘤的患者发生第二原发性恶性肿瘤的发生率增加。
分析了迈克尔·E·德贝基退伍军人事务医疗中心肿瘤登记处（1995 - 2010年）的数据。计算了Kaplan-Meier生存统计量。
在197例MM患者中，33例患者观察到39种不同的癌症，绝大多数发生在MM诊断之前，大多数为早期或预后良好的恶性肿瘤。尽管如此，患有第二或第三种癌症的患者的预后明显差于无其他癌症的患者。值得注意的是，有相当数量的前列腺癌为既往存在的恶性肿瘤。
目前，大多数其他癌症（MM为继发性恶性肿瘤）可能与骨髓瘤治疗无关，而是由于潜在的免疫、遗传或环境因素。需要开展更大规模的研究并进行仔细随访监测，特别是对于接受新型药物治疗的低风险患者。
