Long-Term Data Show Low Risk of Second Primary Malignancy, Transformation in WM
Study shows risk of second primary malignancy or transformation to lymphoma is low.
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Fewer than 1 in 10 patients with symptomatic Waldenstrom macroglobulinemia (WM) will have a second primary malignancy (SPM) or transformation to lymphoma, according to a study presented at the 2018 American Society of Hematology (ASH) Annual Meeting, in San Diego, California. This corresponds to an incidence rate of about 1 case of second primary malignancy and 0.5 cases of transformation per 100 patients annually, respectively.
The results were presented by Maria Gavriotopououa, MD, of National and Kapodistrian University of Athens, Greece.
The study reviewed 598 patients with symptomatic WM registered in the Greek Myeloma Study Group database, where second malignancy and disease transformation is recorded. In a median follow-up of 114 months, 47% of patients had died.
The primary treatment for included patients was alkylating agents (78%) or rituximab based (65%).
A second tumor after initiation of treatment for WM was diagnosed in fewer than 1 in 10 patients (7.7%). The median time from treatment start to diagnosis of second primary malignancy was 51 months. The most commonly occurring malignancy was prostate cancer (18%) followed by stomach (6%), colon (6%), lung (6%), pancreas (3%), non-melanoma skin (3%), central nervous system (6%), and AML/MDS (6%).
In only 2% of patients did the second malignancy proceed the diagnosis of WM.
The cumulative incidence of a second primary malignancy at 5 years was 3.6%, and at 10 years was 6.6%. Risk of death from WM or other causes was 22.5% at 5 years and 46% at 10 years.
Few patients had transformation events (3.1%). The median time from treatment initiation to transformation was 51 months. The cumulative risk for transformation was 2.2% at 5 years and 3.6% at 10 years. Presence of anemia at diagnosis was associated with increased risk for transformation and use of rituximab in the first line was associated with a decreased risk.
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- Gavriatopoulou M, Kastritis E, Ntanasis-Stathopoulos I, et al. Second primary malignancies and disease transformation in newly diagnosed symptomatic patients with Waldenstrom's macroglobulinemia: an analysis from the Greek Myeloma Study Group. Poster presentation at: American Society of Hematology 60th Annual Meeting & Exposition; December 1-4, 2018; San Diego, CA. Abstract 1978.