[Second primary malignancies after the treatment of multiple myeloma]

Outcome of the patients with multiple myeloma has improved significantly in the last decade, mainly because of the introduction of new agents such as thalidomide, bortezomib and lenalidomide. Improvements in survival among patients with multiple myeloma suggest that the incidence of second primary malignancies (SPMs) may increase in the future. Many factors could affect increasing the risk of SPMs, such as treatment factors, myeloma related factors, host genetic factors, and so on. Especially, previous clinical trials suggested that extended exposure to the melphalan and lenalidomide containing regimens are the important risk factors of SPMs. Although numbers of SPMs are small, for individual patients who develop SPMs, the outcomes are devastating. Therefore, we need to discuss not only the efficacy but also the risks of SPMs associated with the treatment in the patients with multiple myeloma in new agents era.