title: Multiple myeloma and other malignancies: a pilot study from the Houston VA.
abstract: BACKGROUND
  The prognosis of multiple myeloma (MM) has improved in recent years. Therefore, second malignant neoplasms (SMNs) may become an issue for longer term survivors with MM. An increased incidence of second malignancies was reported in patients who received lenalidomide for relapsed or refractory myeloma.
  
  
  METHODS
  Data from the Tumor Registry of the Michael E. DeBakey VA Medical Center (1995-2010) were analyzed. Kaplan-Meier survival statistics were calculated.
  
  
  RESULTS
  In 197 patients with MM, 39 different cancers were observed in 33 patients, the large majority occurring before the diagnosis of MM, with most being early-stage or good-prognosis malignancies. Despite this, the prognosis of patients with a second or third cancer was clearly inferior to patients without other cancers. Notable was a significant number of prostate cancers as preexisting malignancies.
  
  
  CONCLUSIONS
  At present, most other cancers (for which MM is the secondary malignancy) may not be related to the treatment for myeloma, but due to underlying immunologic, genetic, or environmental factors. Larger studies and careful follow-up, especially in good-risk patients treated with novel agents, are indicated.
authors.affiliation: Louisiana State University, Health Sciences Center, Shreveport, LA. Electronic address: rmunke@lsuhsc.edu.
authors.forename: Reinhold
authors.initials: R
authors.lastname: Munker
authors.affiliation: Louisiana State University, Health Sciences Center, Shreveport, LA.
authors.forename: Runhua
authors.initials: R
authors.lastname: Shi
authors.affiliation: Baylor College of Medicine, Houston, TX.
authors.forename: Derek
authors.initials: D
authors.lastname: Lin
authors.affiliation: Baylor College of Medicine, Houston, TX.
authors.forename: Shan
authors.initials: S
authors.lastname: Guo
authors.affiliation: Michael E. DeBakey VA Medical Center, Houston, TX; Baylor College of Medicine, Houston, TX.
authors.forename: Teresa G
authors.initials: TG
authors.lastname: Hayes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000453:epidemiology; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000453:epidemiology; D010865:Pilot Projects; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D017741:Survivors / Q000706:statistics & numerical data; D013781:Texas; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs
chemical_list: D020533:Angiogenesis Inhibitors; D013792:Thalidomide; D000077269:Lenalidomide
keywords: Carcinogenesis; Multiple myeloma; Other malignancies