Vol 8, No 2 (2017)
Case report
Published online: 2017-09-06

open access

Page views 1097
Article views/downloads 2229
Get Citation

Connect on Social Media

Connect on Social Media

Coexistence of plasma cell dyscrasias and myelodysplastic syndrome — study of cases and review of literature

Aleksandra Gołos1, Anna Paczek1, Ewa Lech-Marańda12, Krzysztof Warzocha1, Joanna Góra-Tybor1
Hematologia 2017;8(2):144-151.

Abstract

The improvement in plasma cell myeloma (PCM) treatment and much longer overall survival of the patients led to the observation of long-term complications of the therapy. These include secondary malignancies, such as myelodysplastic syndromes (MDS) and acute myeloid leukemia. Definitely less common is the co-occurrence of MDS at the point of diagnosis of PCM or MDS evolving during the observation of untreated patients with monoclonal gammapathy of undetermined significance. In the article we describe 5 patients: one with a therapy-related MDS, the co-occurrence of both diseases from the diagnosis and MDS preceding PCM for several years.

References

  1. Osgood EE. The survival time of patients with plasmocytic myeloma. Cancer Chemother Rep. 1960; 9: 1–10.
  2. Pozzi S, Marcheselli L, Bari A, et al. Survival of multiple myeloma patients in the era of novel therapies confirms the improvement in patients younger than 75 years: a population-based analysis. Br J Haematol. 2013; 163(1): 40–46.
  3. Kyle RA, Pierre RV, Bayrd ED. Multiple myeloma and acute myelomonocytic leukemia. N Engl J Med. 1970; 283(21): 1121–1125.
  4. Rosner F, Grünwald H. Multiple myeloma terminating in acute leukemia. Report of 12 cases and review of the literature. Am J Med. 1974; 57(6): 927–939.
  5. Mailankody S, Pfeiffer RM, Kristinsson SY, et al. Risk of acute myeloid leukemia and myelodysplastic syndromes after multiple myeloma and its precursor disease (MGUS). Blood. 2011; 118(15): 4086–4092.
  6. Rifkin RM, Abonour R, Shah JJ, et al. Connect MM® — the Multiple Myeloma Disease Registry: incidence of second primary malignancies in patients treated with lenalidomide. Leuk Lymphoma. 2016; 57(9): 2228–2231.
  7. Copplestone JA, Mufti GJ, Hamblin TJ, et al. Immunological abnormalities in myelodysplastic syndromes. II. Coexistent lymphoid or plasma cell neoplasms: a report of 20 cases unrelated to chemotherapy. Br J Haematol. 1986; 63(1): 149–159.
  8. Yoshida Y, Oguma S, Ohno H, et al. Co-occurrence of monoclonal gammopathy and myelodysplasia: a retrospective study of fourteen cases. Int J Hematol. 2014; 99(6): 721–725.
  9. Mufti GJ, Hamblin TJ, Clein GP, et al. Coexistent myelodysplasia and plasma cell neoplasia. Br J Haematol. 1983; 54(1): 91–96.
  10. Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010. CA Cancer J Clin. 2010; 60(5): 277–300.
  11. Disenzieri A, Lacy M, Greipp P. Multile myeloma. In: Greer J, Foerster J, Rodgers G. ed. Wintrob's clinical hematology. Wolters Kluwer Health/Liippincott Williams & Wilkins, Philadelphia 2009: 2417–2418.
  12. Bergsagel DE, Bailey AJ, Langley GR, et al. The chemotherapy on plasma-cell myeloma and the incidence of acute leukemia. N Engl J Med. 1979; 301(14): 743–748.
  13. Bergsagel DE, Bailey AJ, Langley GR, et al. The chemotherapy on plasma-cell myeloma and the incidence of acute leukemia. N Engl J Med. 1979; 301(14): 743–748.
  14. Greene MH, Harris EL, Gershenson DM, et al. Melphalan may be a more potent leukemogen than cyclophosphamide. Ann Intern Med. 1986; 105(3): 360–367.
  15. Cuzick J, Erskine S, Edelman D, et al. A comparison of the incidence of the myelodysplastic syndrome and acute myeloid leukaemia following melphalan and cyclophosphamide treatment for myelomatosis. A report to the Medical Research Council's working party on leukaemia in adults. Br J Cancer. 1987; 55(5): 523–529.
  16. Attal M, Harousseau JL, Stoppa AM, et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Français du Myélome. N Engl J Med. 1996; 335(2): 91–97.
  17. Govindarajan R, Jagannath S, Flick JT, et al. Preceding standard therapy is the likely cause of MDS after autotransplants for multiple myeloma. Br J Haematol. 1996; 95(2): 349–353.
  18. Barlogie B, Tricot G, Haessler J, et al. Cytogenetically defined myelodysplasia after melphalan-based autotransplantation for multiple myeloma linked to poor hematopoietic stem-cell mobilization: the Arkansas experience in more than 3,000 patients treated since 1989. Blood. 2008; 111(1): 94–100.
  19. Pemmaraju N, Shah D, Kantarjian H, et al. Characteristics and outcomes of patients with multiple myeloma who develop therapy-related myelodysplastic syndrome, chronic myelomonocytic leukemia, or acute myeloid leukemia. Clin Lymphoma Myeloma Leuk. 2015; 15(2): 110–114.
  20. Monaghan SA, Dai L, Mapara MY, et al. Longitudinal bone marrow evaluations for myelodysplasia in patients with myeloma before and after treatment with lenalidomide. Leuk Lymphoma. 2013; 54(9): 1965–1974.
  21. Usmani SZ, Sexton R, Hoering A, et al. Second malignancies in total therapy 2 and 3 for newly diagnosed multiple myeloma: influence of thalidomide and lenalidomide during maintenance. Blood. 2012; 120(8): 1597–1600.
  22. Malenda A, Kołkowska-Leśniak A, Szumera-Ciećkiewicz A, et al. Skuteczność lenalidomidu u chorego na szpiczaka plazmocytowego współistniejącego z zespołem mielodysplastycznym związanym z izolowaną delecją chromosomu 5q–. Hematologia. 2016; 7(1): 77–84.
  23. Roeker LE, Larson DR, Kyle RA, et al. Risk of acute leukemia and myelodysplastic syndromes in patients with monoclonal gammopathy of undetermined significance (MGUS): a population-based study of 17 315 patients. Leukemia. 2013; 27(6): 1391–1393.
  24. Korde N, Kristinsson SY, Landgren O. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM): novel biological insights and development of early treatment strategies. Blood. 2011; 117(21): 5573–5581.
  25. Greenberg PL, Tuechler H, Schanz J. Revised international prognostic scoring system for myelodysplastic syndromes. Blood. 2012; 120(12): 2454–2465.
  26. Nolte F, Mossner M, Jann JC, et al. Concomitant MDS with isolated 5q deletion and MGUS: case report and review of molecular aspects. Eur J Haematol. 2017; 98(3): 302–310.
  27. Takahashi K, Wang F, Kantarjian H, et al. Preleukaemic clonal haemopoiesis and risk of therapy-related myeloid neoplasms: a case-control study. Lancet Oncol. 2017; 18(1): 100–111.
  28. Busque L, Patel JP, Figueroa ME, et al. Recurrent somatic TET2 mutations in normal elderly individuals with clonal hematopoiesis. Nat Genet. 2012; 44(11): 1179–1181.
  29. Jaiswal S, Fontanillas P, Flannick J, et al. Age-related clonal hematopoiesis associated with adverse outcomes. N Engl J Med. 2014; 371(26): 2488–2498.
  30. Steensma DP, Bejar R, Jaiswal S, et al. Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes. Blood. 2015; 126(1): 9–16.
  31. Genovese G, Kähler AK, Handsaker RE, et al. Clonal hematopoiesis and blood-cancer risk inferred from blood DNA sequence. N Engl J Med. 2014; 371(26): 2477–2487.