Rollison Dana E, Komrokji Rami, Lee Ji-Hyun, Hampras Shalaka, Fulp William, Fisher Kate, Baz Rachid, Nishihori Taiga, Xu Qiang, Olesnyckyj Marta, Kenvin Laurie, Knight Robert, Sullivan Daniel, Alsina Melissa, Dalton William, Shain Kenneth H
a Department of Cancer Epidemiology , Moffitt Cancer Center , Tampa , FL , USA.
b Department of Malignant Hematology , Moffitt Cancer Center , Tampa , FL , USA.
Leuk Lymphoma. 2017 Mar;58(3):560-568. doi: 10.1080/10428194.2016.1207763. Epub 2016 Jul 18.
Risk of subsequent primary malignancies (SPMs) associated with lenalidomide therapy in multiple myeloma (MM) patients, outside the context of melphalan-based therapy is not established. We assessed the risk of SPMs in lenalidomide treated MM patients (n = 1653) at Moffitt Cancer Center (2004-2012) outside the context of melphalan-based induction therapy and post-melphalan maintenance therapy, via (1) cohort analysis and (2) nested case-control study. Incident SPMs (n = 51) were matched to controls (n = 102) on age at MM diagnosis, gender, follow-up time, and date of diagnosis. Incidence of SPM differed significantly (p = 0.0038) between MM patients treated with and without lenalidomide (5-year incidence estimates of 3.2 and 6.2%, respectively), although not significant after adjustment for age and year of diagnosis (HR = 0.82, 95%CI = 0.43-1.57). Lenalidomide treatment was inversely associated with SPM in the nested case-control analysis (OR = 0.03, 95%CI = 0.002-0.34). In this large cohort of MM patients, lenalidomide treatment was not associated with an increased risk of SPM.
在多发性骨髓瘤（MM）患者中，来那度胺治疗相关的后续原发性恶性肿瘤（SPM）风险（不包括基于美法仑的治疗情况）尚未明确。我们在莫菲特癌症中心（2004 - 2012年）对1653例接受来那度胺治疗的MM患者（不包括基于美法仑的诱导治疗和美法仑后维持治疗情况）进行评估，通过（1）队列分析和（2）巢式病例对照研究来评估SPM风险。将51例新发SPM病例与102例对照在MM诊断时的年龄、性别、随访时间和诊断日期方面进行匹配。接受来那度胺治疗和未接受来那度胺治疗的MM患者之间SPM的发生率有显著差异（p = 0.0038）（5年发生率估计分别为3.2%和6.2%），尽管在调整年龄和诊断年份后差异不显著（HR = 0.82，95%CI = 0.43 - 1.57）。在巢式病例对照分析中，来那度胺治疗与SPM呈负相关（OR = 0.03，95%CI = 0.002 - 0.34）。在这个大型MM患者队列中，来那度胺治疗与SPM风险增加无关。
