Previous Cancer Diagnoses Associated with Subsequent Development of Multiple Myeloma

February 10, 2021
Matthew Fowler

Data regarding patients with previous Hodgkin lymphoma and primary myelofibrosis diagnoses found associations with subsequent diagnosis of multiple myeloma.

Previous Hodgkin lymphoma and primary myelofibrosis diagnoses were associated with a subsequent identification of multiple myeloma, while the overall incidence rates of previous cancers were not found to be increased for these patients, according to data published in the European Journal of Haematology.

“We demonstrate that the overall incidence of previous cancers in [patients with multiple myeloma] is not greater than in an age-matched control cohort,” wrote the investigators. “We found significant associations between Hodgkin lymphoma and primary myelofibrosis and the subsequent development of [multiple myeloma]. With regards to [second primary malignancies], the well-known increased risk for [acute myeloid leukemia/myelodysplastic syndrome (AML/MDS)] is further underlined by our study.”

To further specify, the data found diagnoses of Hodgkin lymphoma (odds ratio [OR], 3.66; 95% CI, 1.40-9.55) and myeloproliferative neoplasms (MPNs; OR, 3.57; 95% CI,1.45-8.80) were associated with multiple myeloma diagnoses. Specifically, for MPNs, that association was determined by a number of cases of primary myelofibrosis in the multiple myeloma group.

When comparing the multiple myeloma group with the control group, no difference was observed for the overall incidence of a previous malignancy (OR, 0.93; 95% CI, 0.87-1.00). Patients in the multiple myeloma group were at an increased risk of developing secondary AML/MDS (HR 6.1, 95% CI: 3.9-9.5).

The research team utilized data from 9574 patients with multiple myeloma accessed via the Cancer Registry of Norway. They matched this group with 37,810 control subjects and analyzed the association with previous malignancies using a logistic regression model. The team then used a Cox model to measure the risk of second primary malignancies.

“The association between a previous MPNs diagnosis and [multiple myeloma] was also consistent in both the main and sensitivity analyses,” wrote the investigators. “Apart from one, all cases of MPNs in the [multiple myeloma] group were diagnosed more than one year prior to the myeloma.”

The research team detailed the limitations of the study, including the lack of specific individual information regarding treatment, disease characteristics, and comorbidity. Moreover, even though the data analyzed almost 10,000 patients with multiple myeloma, the number of cases for previous cancers were low, warranting “cautious interpretation,” according to the investigators.

The main strength of the research highlights the population-based design of the study with access to data from a reliable cancer registry.

“To our knowledge, this is the first study assessing the previous cancer history in [patients with multiple myeloma] compared to a reference population,” wrote the investigators. “Patients with [multiple myeloma] had a previous cancer history with significantly increased incidence of [non-Hodgkin lymphoma, Hodgkin lymphoma,] and MPN.”

Reference:

Langseth OO, Myklebust TA, Johannesen TB, et al. Patterns of previous and secondary malignancies in patients with multiple myeloma. European Journal of Haematology. doi: 10.1111/ejh.13581