Those patients with a history of lenalidomide use had a lower risk for death among transplant-eligible (P = .0326) and ineligible (P < .001) patients.

Dr Yamasaki and colleagues acknowledged several limitations to their study, including its retrospective nature and the small number of patients included. In addition, patients who died from therapy-related adverse events were not included, and the risk of SPM in these patients could not be determined.

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Dr Fung told Cancer Therapy Advisor that he was not surprised by the rate of SPM seen in this study population and that screening for SPM is now a regular part of standard care for patients with myeloma.

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“Myeloma patients live longer and longer,” Dr Fung said. “Development of SPM is relatively common, and long-term follow-up with an oncologist is essential for early detection and intervention.”

Dr Yamasaki and colleagues noted that although occurrence of an SPM did not predict overall survival after diagnosis in this study, SPMs are “clinically and psychologically devastating for patients.”

“Further optimization of novel agents for both transplant-eligible and transplant-ineligible multiple myeloma patients might increase life expectancy and reduce risk of developing SPMs,” they wrote.


1. Yamasaki S, Yoshimoto G, Kohno K, et al. Risk of secondary primary malignancies in multiple myeloma patients with or without autologous stem cell transplantation [published online September 24, 2018].  Int J Hematol. doi: 10.1007/s12185-018-2538-8