MM-423: Secondary Hematologic Malignancies in Patients With Multiple Myeloma: A Retrospective Analysis of Risk Factors and Incidence in a Large Urban Health System
Recommended Citation
Zimmer M, Abad JT, Gupta J, Ghosh S, Kuriakose P. MM-423: Secondary Hematologic Malignancies in Patients With Multiple Myeloma: A Retrospective Analysis of Risk Factors and Incidence in a Large Urban Health System. 2025; :S919.
Document Type
Conference Proceeding
Publication Date
9-1-2025
Abstract
Multiple myeloma (MM) is a common hematologic malignancy. While overall survival has improved due to advances in therapy, there is concern regarding the risk of secondary hematologic malignancies (SHM). Objective: To identify patients treated for MM who subsequently developed SHM and estimate the incidence and timing of SHM. Design: Retrospective, observational study. Setting: Henry Ford Health, a large urban, tertiary care network in Detroit, MI. Patients: Patients age 18 years or more with a confirmed diagnosis of MM between January 2005 and December 2022 and a subsequent SHM diagnosis were identified through electronic medical records review. Results: Of 3122 patients with MM, 297 were identified by automatic data pull as having a diagnosis of SHM. After manual review, nine patients met the inclusion criteria. Six patients (66.7%) were male. Median age at MM diagnosis was 62 (range: 53–73) years. About 44.4% were African American, 33.3% were Caucasian, 11.1% were Asian, and 11.1% identified as other. At a median follow-up of 58 (range: 35–144) months, most patients (66.6%) had received only one line of therapy, some had two lines (22.25%), and one patient had received 12 lines of therapy. Five patients (55.6%) underwent autologous stem cell transplantation. Most patients (77.8%) received maintenance therapy, most commonly with lenalidomide (66.7%), for a median duration of 11 (range: 0–29) months. SHM were diagnosed at a median of 4 years after MM diagnosis, being primarily myeloid in origin (77.8%). Median time from MM diagnosis to death was 64 (range: 49–78) months, and median time from SHM diagnosis to death was 5 (range: 0–9) months. Conclusion: Despite the sample size and retrospective nature, our study has some key findings. First, the incidence of SHM was 0.2%, which is significantly less than the 8–18% in previous studies. Second, most patients were not heavily pretreated, often receiving only 1–2 lines of therapy and shorter duration of lenalidomide maintenance prior to the development of SHM. Accordingly, further work needs to be done to evaluate the impact of both patient- and disease-dependent factors, as well as MM therapy, on the development of SHM.
First Page
S919
