ArticleBlood cancer journal2026
Characteristics and outcomes of secondary hematological malignancies following autologous stem cell transplantation for multiple myeloma.
Article in Blood cancer journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Autologous stem cell transplantation (auto-SCT) remains an important pillar in multiple myeloma (MM) therapy; however, there is an increased risk of developing second primary malignancy including second hematological malignancy (SHM). We performed a retrospective study of patients with MM who underwent an auto-SCT at our institution between 1990 and 2022 and subsequently developed SHM. Among 3401 patients with MM who underwent auto-SCT, 110 (3.2%) developed SHM [therapy related myeloid neoplasm (t-MN) = 98; acute B cell lymphoblastic leukemia (t-B-ALL) = 11 and mixed phenotype acute leukemia=1). The cumulative incidence of SHM has increased between the pre-novel (auto-SCT, 1990-2006) and novel agent eras (2007- 2022) (1.1% vs 2.0% at 60 months; P = 0.03). Somatic mutations in TP 53 gene were seen in 40% of patients with t-MN. Among t-B-ALL patients, high incidence of hypodiploidy (n = 4) and IKZF1 (n = 3) deletion was observed. In multivariate analysis, receiving an alkylator based induction, radiation therapy, achieving a complete response after auto-SCT, use of cyclophosphamide for stem cell mobilization and lenalidomide maintenance were independent predictors of developing SHM. Patients with MM who developed a SHM had an inferior overall survival (OS). Given the median OS for MM continues to improve, monitoring for SHM and risk mitigation strategies is crucial.
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