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Second malignancies in the context of lenalidomide treatment: an analysis of 2732 myeloma patients enrolled to the Myeloma XI trial.

Jones, J R and Cairns, D A and Gregory, W M and Collett, C and Pawlyn, C and Sigsworth, R and Striha, A and Henderson, R and Kaiser, M F and Jenner, M and Cook, G and Russell, N H and Williams, C and Pratt, Guy and Kishore, B and Lindsay, J and Drayson, M T and Davies, F E and Boyd, K D and Owen, R G and Jackson, G H and Morgan, G J (2016) Second malignancies in the context of lenalidomide treatment: an analysis of 2732 myeloma patients enrolled to the Myeloma XI trial. Blood cancer journal, 6 (12). e506. ISSN 2044-5385. This article is available to all HEFT staff and students via ASK HEFT Discovery tool http://tinyurl.com/z795c8c using their Athens Login

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Official URL: http://www.nature.com/bcj/journal/v6/n12/full/bcj2...

Abstract

We have carried out the largest randomised trial to date of newly diagnosed myeloma patients, in which lenalidomide has been used as an induction and maintenance treatment option and here report its impact on second primary malignancy (SPM) incidence and pathology. After review, 104 SPMs were confirmed in 96 of 2732 trial patients. The cumulative incidence of SPM was 0.7% (95% confidence interval (CI) 0.4-1.0%), 2.3% (95% CI 1.6-2.7%) and 3.8% (95% CI 2.9-4.6%) at 1, 2 and 3 years, respectively. Patients receiving maintenance lenalidomide had a significantly higher SPM incidence overall (P=0.011). Age is a risk factor with the highest SPM incidence observed in transplant non-eligible patients aged >74 years receiving lenalidomide maintenance. The 3-year cumulative incidence in this group was 17.3% (95% CI 8.2-26.4%), compared with 6.5% (95% CI 0.2-12.9%) in observation only patients (P=0.049). There was a low overall incidence of haematological SPM (0.5%). The higher SPM incidence in patients receiving lenalidomide maintenance therapy, especially in advanced age, warrants ongoing monitoring although the benefit on survival is likely to outweigh risk.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK HEFT Discovery tool http://tinyurl.com/z795c8c using their Athens Login
Subjects: QZ Pathology. Oncology
WH Haemic and lymphatic systems. Haematology
Divisions: Planned IP Care > Oncology and Clinical Haematology
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Depositing User: Mrs Caroline Tranter
Date Deposited: 03 Feb 2017 12:23
Last Modified: 03 Feb 2017 12:23
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1168

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