The impact of prior malignancies on second malignancies and survival in MM patients: A population-based study

Gudbjorg Jonsdottir, Sigrun H. Lund, Magnus Bjorkholm, Ingemar Turesson, Malin Hultcrantz, Anna Porwit, Yogesh S. Jethava, Ola Landgren, Sigurdur Y. Kristinsson

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12 Scopus citations


In the present study, we aimed to evaluate 2 hypotheses. First, we hypothesize that prior malignancy is a proxy for genetic susceptibility that could be a risk factor for subsequent malignancy development in multiple myeloma (MM) patients. Second, we hypothesize that survival after MM is influenced by a prior malignancy. All patients diagnosed with MM from 1 January 1973 to 31 December 2010 were identified from the Swedish Cancer Register. Cox regression model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) where prior malignancy was compared in MM patients who developed a subsequent malignancy and MM patients who did not. In another Cox regression model, survival was compared inMMpatients with and without a prior malignancy diagnosis.Atotal of 19 791 patients were diagnosed with MM. Patients with a prior malignancy diagnosis had a significantly increased risk of developing a subsequent malignancy compared with MM patients without (HR 1.42, 95% CI 1.23-1.65, P < .001). MM patients with a prior malignancy diagnosis had a significant 1.21-fold increased risk of death (95% CI 1.115-1.26, P < .001) compared with MM patients without. MM patients with 2 or more prior malignancy diagnoses had a 1.34-fold increased risk of death (95% CI 1.19-1.52, P < .001). In this large population-based study, we report that prior malignancy increases the risk of subsequent malignancy development in MM patients. Furthermore, we found that prior malignancy negatively impacts survival and that >1 prior malignancy reduces survival even further.

Original languageEnglish (US)
Pages (from-to)2392-2398
Number of pages7
JournalBlood Advances
Issue number25
StatePublished - Nov 28 2017
Externally publishedYes

ASJC Scopus subject areas

  • Hematology


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