title: New cancers after autotransplantations for multiple myeloma.
abstract: We describe baseline incidence and risk factors for new cancers in 4161 persons receiving autotransplants for multiple myeloma in the United States from 1990 to 2010. Observed incidence of invasive new cancers was compared with expected incidence relative to the US population. The cohort represented 13,387 person-years at-risk. In total, 163 new cancers were observed, for a crude incidence rate of 1.2 new cancers per 100 person-years and cumulative incidences of 2.6% (95% confidence interval [CI], 2.09 to 3.17), 4.2% (95% CI, 3.49 to 5.00), and 6.1% (95% CI, 5.08 to 7.24) at 3, 5, and 7 years, respectively. The incidence of new cancers in the autotransplantation cohort was similar to age-, race-, and gender-adjusted comparison subjects with an observed/expected (O/E) ratio of 1.00 (99% CI, .81 to 1.22). However, acute myeloid leukemia and melanoma were observed at higher than expected rates with O/E ratios of 5.19 (99% CI, 1.67 to 12.04; P = .0004), and 3.58 (99% CI, 1.82 to 6.29; P < .0001), respectively. Obesity, older age, and male gender were associated with increased risks of new cancers in multivariate analyses. This large data set provides a baseline for comparison and defines the histologic type specific risk for new cancers in patients with MM receiving postautotransplantation therapies, such as maintenance.
authors.affiliation: University of California San Francisco, California.
authors.forename: Anuj
authors.initials: A
authors.lastname: Mahindra
authors.affiliation: Jefferson Regional Medical Center, Pine Bluff, Arkansas.
authors.forename: Girindra
authors.initials: G
authors.lastname: Raval
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, Arkansas; Central Arkansas Veterans Healthcare System, Little Rock, Arkansas.
authors.forename: Paulette
authors.initials: P
authors.lastname: Mehta
authors.affiliation: Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Ruta
authors.initials: R
authors.lastname: Brazauskas
authors.affiliation: Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Mei-Jie
authors.initials: MJ
authors.lastname: Zhang
authors.affiliation: Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Zhong
authors.affiliation: University Hospitals Bristol NHS Trust, Bristol, United Kingdom.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Bird
authors.affiliation: South Texas Veterans Health Care System and University of Texas Health Science Center San Antonio, San Antonio, Texas.
authors.forename: César O
authors.initials: CO
authors.lastname: Freytes
authors.affiliation: All Children's Hospital, St. Petersburg, Florida.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Hale
authors.affiliation: James Brown Cancer Center, University of Louisville Hospital, Louisville, Kentucky.
authors.forename: Roger
authors.initials: R
authors.lastname: Herzig
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Leona A
authors.initials: LA
authors.lastname: Holmberg
authors.affiliation: Baylor College of Medicine Center for Cell and Gene Therapy, Houston, Texas.
authors.forename: Rammurti T
authors.initials: RT
authors.lastname: Kamble
authors.affiliation: Mayo Clinic Rochester, Rochester, Minnesota.
authors.forename: Shaji
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio.
authors.forename: Hillard M
authors.initials: HM
authors.lastname: Lazarus
authors.affiliation: Cleveland Clinic, Cleveland, Ohio.
authors.forename: Navneet S
authors.initials: NS
authors.lastname: Majhail
authors.affiliation: University Hospitals Bristol NHS Trust, Bristol, United Kingdom.
authors.forename: David I
authors.initials: DI
authors.lastname: Marks
authors.affiliation: Shands HealthCare and University of Florida, Gainesville, Florida.
authors.forename: Jan S
authors.initials: JS
authors.lastname: Moreb
authors.affiliation: Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
authors.forename: Richard
authors.initials: R
authors.lastname: Olsson
authors.affiliation: Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Wael
authors.initials: W
authors.lastname: Saber
authors.affiliation: Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Bipin N
authors.initials: BN
authors.lastname: Savani
authors.affiliation: UCLA Center for Health Sciences, Los Angeles, California.
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Schiller
authors.affiliation: University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: Tay
authors.affiliation: Abramson Cancer Center University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.
authors.forename: Dan T
authors.initials: DT
authors.lastname: Vogl
authors.affiliation: Winship Cancer Institute, Emory University Hospital, Atlanta, Georgia.
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Waller
authors.affiliation: Our Lady of Mercy Medical Center, Bronx, New York.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Wiernik
authors.affiliation: Stony Brook University Medical Center, Stony Brook, New York.
authors.forename: Baldeep
authors.initials: B
authors.lastname: Wirk
authors.affiliation: Winship Cancer Institute, Emory University Hospital, Atlanta, Georgia.
authors.forename: Sagar
authors.initials: S
authors.lastname: Lonial
authors.affiliation: City of Hope National Medical Center, Duarte, California.
authors.forename: Amrita Y
authors.initials: AY
authors.lastname: Krishnan
authors.affiliation: Mayo Clinic Rochester, Rochester, Minnesota.
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.affiliation: Celgene Corporation, Summit, New Jersey.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Brandenburg
authors.affiliation: Imperial College, London, United Kingdom.
authors.forename: Robert Peter
authors.initials: RP
authors.lastname: Gale
authors.affiliation: Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: phari@mcw.edu.
authors.forename: Parameswaran N
authors.initials: PN
authors.lastname: Hari
mesh_terms: D000293:Adolescent; D064592:Autografts; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009101:Multiple Myeloma / Q000453:epidemiology* / Q000628:therapy*; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D033581:Stem Cell Transplantation; D014481:United States / Q000453:epidemiology
keywords: Myeloma; Second cancer; Transplantation