Key clinical point: Increased cumulative exposure to the alkylating agent melphalan increases the subsequent risk for developing acute myeloid leukemia/myelodysplastic syndromes (AML/MDS) in patients with multiple myeloma (MM).
Major finding: Cumulative exposure to melphalan was significantly higher (odds ratio, 2.8; P less than .001) among patients with MM and AML/MDS (median, 988 mg) than control participants (median, 578 mg). The median time to development of AML/MDS was 3.8 years.
Study details: The study included 26,627 patients diagnosed with MM between 1985 and 2011, of which 124 (0.5%) patients developed subsequent AML/MDS. Each patient with MM and AML/MDS diagnosis was matched with a control MM patient without AML/MDS.
Disclosures: The study was supported by grants from the Asrun Einarsdottir Foundation in Iceland, University of Iceland Research Fund, Icelandic Centre for Research, Landspitali University Hospital Research Fund, Thorman’s foundation, and Sylvester Comprehensive Cancer Center NCI Core Grant. O Landgren and M Björkholm reported ties with various pharmaceutical companies. The remaining authors declared no conflicts of interest.
Source: Jonsdottir G et al. Eur J Haematol. 2021 May 9. doi: 10.1111/ejh.13650 .