The advent of novel agents for multiple myeloma (MM) is cause for a re-examination of the incidence of second primary malignancies (SPMs). We examined the SPM rate in MM patients who were enrolled in the prospective observational CALM (Collaboration to Collect Autologous Transplant outcome in Lymphoma and Myeloma) study. Between 2008 and 2012, 3204 patients with MM underwent a first autologous hematopoietic stem cell transplantation. Plerixafor was used as a mobilizing agent for patients with poor (or potentially poor) stem cell mobilization as defined by the respective centers. A total of 135 patients developed SPMs, with a cumulative incidence of 5.3% (95% confidence interval, 4.4 to 6.3) at 72 months. Ninety-four patients developed solid tumors, 30 developed hematologic malignancies, and 11 developed an SPM of an unknown type. The cumulative incidence of known hematologic and solid malignancies were 1.4% and 3.6%, respectively, at 72 months. In a univariate analysis, use of radiotherapy, type of induction regimen, hematopoietic stem cell dose, poor mobilizer status, plerixafor use, and sex did not influence the cumulative incidence of SPMs. Only age over 65 years was statistically associated with an increased incidence. Overall, the incidence of SPMs was comparable to earlier estimations of SPMs in MM.

Center for Cancer Research and Cell Biology Queens University of Belfast Belfast United Kingdom

Department of Biology University of Rome Tor Vergata Rome Italy

Department of Haematology Imperial College Hammersmith Hospital London United Kingdom

Department of Haematology Nottingham University Hospital Nottingham United Kingdom

Department of Haematology St James's Hospital Dublin Ireland

Department of Haematology University Hospital of Wales Cardiff United Kingdom

Department of Hematology and Cellular Therapy Hospital Saint Antoine Paris France

Department of Hematology and Hematopoietic Cell Transplantation City of Hope Duarte California

Department of Hematology Charles University Hospital Prague Czech Republic

Department of Hematology CHRU de Lille Lille France

Department of Hematology Hospital Universitario Central de Asturias Oviedo Spain

Department of Hematology Oncology and Clinical Immunology Heinrich Heine Universität Düsseldorf Germany

Department of Hematology Oncology and Internal Medicine Central Clinical Hospital Warsaw Poland

Department of Hematology Radboud University Medical Centre Nijmegen the Netherlands

Department of Hematology Skane University Hospital Lund Sweden

Department of Hematology Umea University Hospital Umeå Sweden

Department of Internal Medicine 1 University of Cologne Cologne Germany

Department of Internal Medicine 5 University of Heidelberg Heidelberg Germany

Department of Internal Medicine Hematology and Oncology University Hospital Brno Brno Czech Republic

Department of Stem Cell Transplantation University Hospital Eppendorf Hamburg Germany

Division of Hematology Department of Medicine Karolinska University Hospital Stockholm Sweden

EBMT Data Office Leiden Leiden the Netherlands

Institut Paoli Calmettes Department of Hematology Centre de Recherche en Cancérologie de Marseille Marseille France

St István and St Laszlo Hospital Budapest Hungary

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