title: A rare case of nasopharyngeal carcinoma in a patient with multiple myeloma after treatment by lenalidomide.
abstract: Multiple myeloma (MM) is a plasma-cell malignancy leading to a significant life-expectancy shortening. Lenalidomide is an oral immunomodulatory drug (IMiD) approved in the United States for patients with MM. Although the introduction of lenalidomide combined with dexamethasone (Len/Dex) has improved the outcome of patients with relapsed/refractory multiple myeloma (RRMM), it is a common knowledge that lenalidomide has been linked to the development of secondary primary malignancies in the MM patients, especially in those who use lenalidomide as a maintenance therapy. In the published literature, these are also many cases reported by clinicians in different secondary primary malignancies after the diagnosis of MM treated with lenalidomide. In this present article, we provided our patient who was identified nasopharyngeal carcinoma (NPC) 46 months after the diagnosis of MM and 21 months after lenalidomide treatment. To the best of our knowledge, this is the first case report related to the occurrence of NPC in a patient with MM after treatment by lenalidomide. Although it is not very sure that the incidence of NPC was associated with the use of lenalidomide, we clinicians should pay adequate attention to this phenomenon in the clinical processing. And much more cooperative studies of large numbers of MM patients are needed to evaluate a possible association between lenalidomide and NPC.
authors.affiliation: Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Gaixiang
authors.initials: G
authors.lastname: Xu
authors.affiliation: Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Min
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Qian
mesh_terms: D002277:Carcinoma; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000473:pathology*; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology*; D016609:Neoplasms, Second Primary / Q000473:pathology*; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D007155:Immunologic Factors; D013792:Thalidomide; D000077269:Lenalidomide
keywords: Nasopharyngeal carcinoma; immunomodulatory drug; lenalidomide; multiple myeloma
references.citation: Int J Clin Exp Pathol. 2014;7(6):3073-80
references.pmid: 25031726
references.citation: Leuk Lymphoma. 2015 Jun;56(6):1723-6
references.pmid: 25284489
references.citation: Haematologica. 2014 Feb;99(2):232-42
references.pmid: 24497560
references.citation: Blood. 2012 Mar 22;119(12):2731-7
references.pmid: 22310913
references.citation: N Engl J Med. 2012 May 10;366(19):1770-81
references.pmid: 22571201
references.citation: Ann Clin Lab Sci. 2013 Spring;43(2):176-80
references.pmid: 23694793
references.citation: Lancet Oncol. 2014 Mar;15(3):333-42
references.pmid: 24525202
references.citation: Int J Clin Exp Pathol. 2014;7(5):2683-9
references.pmid: 24966987
references.citation: Hematol Oncol. 2015 Jul 31;:null
references.pmid: 26228379
references.citation: Curr Med Res Opin. 2012 Jul;28(7):1129-40
references.pmid: 22533678
references.citation: CA Cancer J Clin. 2014 Jan-Feb;64(1):9-29
references.pmid: 24399786
references.citation: N Engl J Med. 2007 Nov 22;357(21):2123-32
references.pmid: 18032762
references.citation: N Engl J Med. 2012 May 10;366(19):1782-91
references.pmid: 22571202