Secondary neoplasms following treatment for multiple myeloma

Multiple myeloma (MM) is a hematologic malignancy characterized by the clonal proliferation of plasma cells within the bone marrow, leading to significant end-organ damage. Recent therapeutic advancements, including immunomodulatory drugs (IMiDs), proteasome inhibitors, autologous stem cell transplant (ASCT), and chimeric antigen receptor T-cell (CAR-T) therapy, have significantly improved survival outcomes. However, with prolonged survival, there is an emerging concern regarding therapy-related secondary malignancies (SM), particularly therapy-related myeloid neoplasms (tMN) and secondary lymphoid neoplasms. This article reviews the incidence, contributing factors, clinicopathological features, and outcomes associated with secondary malignancies in MM patients, including recent observations on therapy-related B-lymphoblastic leukemia and lymphomas.