Abstract
The purpose of this study was to determine if there is an increased risk of acute leukemia and myelodysplastic syndromes (MDS) in persons with monoclonal gammopathy of undetermined significance (MGUS). We used a large population-based cohort of individuals systematically screened for the presence or absence of MGUS. MGUS status was then linked to the diagnosis of acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL) and MDS. A total of 17 315 patients age 50 and older (605 MGUS and 16 710 controls) with a cumulative 435 021 person-years of follow-up were studied. MGUS patients had a significantly higher risk of developing MDS compared with controls, hazard ratio 2.4 (95% CI 1.08, 5.32), P=0.031. There was no statistically significant increase in the risk of AML (RR 1.36 P=0.675), and no increased risk of developing ALL.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Kyle RA, Pierre RV, Bayrd ED . Multiple myeloma and acute myelomonocytic leukemia. N Engl J Med 1970; 283: 1121–1125.
Cuzick J, Erskine S, Edelman D, Galton DA . 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: 523–529.
Bergsagel DE, Bailey AJ, Langley GR, MacDonald RN, White DF, Miller AB . The chemotherapy on plasma-cell myeloma and the incidence of acute leukemia. N Engl J Med 1979; 301: 743–748.
Govindarajan R, Jagannath S, Flick JT, Vesole DH, Sawyer J, Barlogie B et al. Preceding standard therapy is the likely cause of MDS after autotransplants for multiple myeloma. Br J Haematol 1996; 95: 349–353.
Yang J, Terebelo HR, Zonder JA . Secondary primary malignancies in multiple myeloma: an old nemesis revisited. Adv Hematol 2012; 2012: 801495.
McCarthy PL, Owzar K, Hofmeister CC, Hurd DD, Hassoun H, Richardson PG et al. Lenalidomide after stem-cell transplantation for multiple myeloma. N Engl J Med 2012; 366: 1770–1781.
Attal M, Lauwers-Cances V, Marit G, Caillot D, Moreau P, Facon T et al. Lenalidomide maintenance after stem-cell transplantation for multiple myeloma. N Engl J Med 2012; 366: 1782–1791.
Palumbo A, Hajek R, Delforge M, Kropff M, Petrucci MT, Catalano J et al. Continuous lenalidomide treatment for newly diagnosed multiple myeloma. N Engl J Med 2012; 366: 1759–1769.
Thomas A, Mailankody S, Korde N, Kristinsson SY, Turesson I, Landgren O . Second malignancies after multiple myeloma: from 1960 s–2010 s. Blood 2012; 119: 2731–2737.
Travis LB, Rabkin CS, Brown LM, Allan JM, Alter BP, Ambrosone CB et al. Cancer survivorship–genetic susceptibility and second primary cancers: research strategies and recommendations. J Natl Cancer Inst 2006; 98: 15–25.
Kyle RA, Therneau TM, Rajkumar SV, Larson DR, Plevak MF, Offord JR et al. Prevalence of monoclonal gammopathy of undetermined significance. N Engl J Med 2006; 354: 1362–1369.
Kyle RA . Monoclonal gammopathy of undetermined significance. Natural history in 241 cases. Am J Med 1978; 64: 814–826.
Kyle RA, Therneau TM, Rajkumar SV, Offord JR, Larson DR, Plevak MF et al. A long-term study of prognosis in monoclonal gammopathy of undetermined significance. N Engl J Med 2002; 346: 564–569.
Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. Br J Haematol 2003; 121: 749–757.
Bida JP, Kyle RA, Therneau TM, Melton LJ, Plevak MF, Larson DR et al. Disease associations with monoclonal gammopathy of undetermined significance: a population-based study of 17,398 patients. Mayo Clinic Proceedings 2009; 84: 685–693.
Mailankody S, Pfeiffer RM, Kristinsson SY, Korde N, Bjorkholm M, Goldin LR et al. Risk of acute myeloid leukemia and myelodysplastic syndromes after multiple myeloma and its precursor disease (MGUS). Blood 2011; 118: 4086–4092.
Acknowledgements
This work was supported in part by the National Cancer Institute, National Institutes of Health, Bethesda, MD (CA107476, CA168762, CA100707, CA 83724). Also supported in part by the Jabbs Foundation, Birmingham, United Kingdom and the Henry J. Predolin Foundation, USA.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Additional information
Author contributions
LER, RAK and SVR designed the research, wrote and edited the manuscript. DRL analyzed the data. SK and AD participated in data interpretation, reviewed the manuscript and provided critical comments. All authors reviewed and approved the final manuscript.
Rights and permissions
About this article
Cite this article
Roeker, L., Larson, D., Kyle, R. 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 27, 1391–1393 (2013). https://doi.org/10.1038/leu.2013.34
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/leu.2013.34
Keywords
This article is cited by
-
Characteristics and outcomes of therapy-related myeloid neoplasms following autologous stem cell transplantation for multiple myeloma
Blood Cancer Journal (2021)
-
Percorso di laboratorio raccomandato nella diagnosi, prognosi e follow-up delle gammopatie monoclonali
La Rivista Italiana della Medicina di Laboratorio - Italian Journal of Laboratory Medicine (2017)
-
Two cases of chronic myelomonocytic leukemia combined with monoclonal gammopathy of undetermined significance and a literature review
Oncology and Translational Medicine (2017)
-
Myelopoiesis dysregulation associated to sustained APRIL production in multiple myeloma-infiltrated bone marrow
Leukemia (2015)
-
Variable risk of second primary malignancy in multiple myeloma patients of different ethnic subgroups
Blood Cancer Journal (2014)