New cancers after autotransplantations for multiple myeloma

Anuj Mahindra, Girindra Raval, Paulette Mehta, Ruta Brazauskas, Mei Jie Zhang, Xiaobo Zhong, Jennifer M. Bird, César O. Freytes, Gregory A. Hale, Roger Herzig, Leona A. Holmberg, Rammurti T. Kamble, Shaji Kumar, Hillard M. Lazarus, Navneet S. Majhail, David I. Marks, Jan S. Moreb, Richard Olsson, Wael Saber, Bipin N. SavaniGary J. Schiller, Jason Tay, Dan T. Vogl, Edmund K. Waller, Peter H. Wiernik, Baldeep Wirk, Sagar Lonial, Amrita Y. Krishnan, Angela Dispenzieri, Nancy A. Brandenburg, Robert Peter Gale, Parameswaran N. Hari

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


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 7years, 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.

Original languageEnglish
Pages (from-to)738-745
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Issue number4
StatePublished - 1 Apr 2015
Externally publishedYes


  • Myeloma
  • Second cancer
  • Transplantation


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