Yazarlar : Thomas A, Mailankody S, Korde N, Kristinsson SY, Turesson I, Landgren O.

Yayın : Blood

Yayın Yılı : 2012

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/22323483

Konu : Myelom

Literatür İçeriği :

Abstract

Based on small numbers, recent reports from three randomized trials have consistently demonstrated more hematologic malignancies in patients treated with lenalidomide as maintenance (vs. placebo). This fact has prompted concern and highlighted the association between multiple myeloma and second malignancies. Furthermore, an excess of acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) following multiple myeloma has been known for over four decades. Most prior studies have been restricted due to small numbers of patients, inadequate follow-up, and limitations of ascertainment of second malignancies. Although the underlying biological mechanisms of AML/MDS after multiple myeloma are unknown, treatment-related factors are presumed to be responsible. Recently, an excess risk of AML/MDS was found among 5652 patients with IgG/IgA (but not IgM) monoclonal gammopathy of undetermined significance (MGUS), supporting a role for disease-related factors. Furthermore, there is evidence to suggest that polymorphisms in germline genes may contribute to a person's susceptibility to subsequent cancers, while the potential influence of environmental and behavioral factors remains poorly understood. This review discusses current knowledge regarding second malignancies following multiple myeloma and gives future directions for efforts designed to characterize underlying biological mechanisms, with the goal to maximize survival and minimize the risk for second malignancies for individual patients.

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