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多发性骨髓瘤中第二次原发性恶性瘤的变化格局:在两个治疗期之间进行的一项基于SEER的人口研究

Weixiang Lu¹, Xiaoshan Huang², Shengyu Tian¹

¹Department of Hematology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Cancer control : journal of the Moffitt Cancer Center

|March 4, 2026

概括

在多发性骨髓瘤 (MM) 幸存者中,第二次原发性恶性瘤 (SPMs) 的风险显著增加,近年来SPM发病的时间更短. 加强对MM患者的癌症监测至关重要.

科学领域:

在瘤学瘤学.
流行病学流行病学
癌症的生存率癌症的生存率

背景情况:

蛋白质酶抑制剂和免疫调节剂改善了多发性骨髓瘤 (MM) 的预后.
人们越来越担心MM幸存者的第二次主要恶性瘤 (SPMs).

研究的目的:

评估MM幸存者在不同治疗时期的SPM发病率和特征的变化.
为了比较在不同治疗期间诊断的MM患者之间的SPM风险,潜伏期和生存结果.

主要方法:

使用SEER数据库 (1990-2021) 进行基于人口的回顾性研究.
对26869名MM患者的分析分为两个时代:时代-1 (1990-2005) 和时代-2 (2006-2021).
对 SPMs 的累积发病率,标准化发病率 (SIR) 和总生存率 (OS) 的比较.

主要成果:

15年累计发生的SPMs在Era-2 (7.7%) 与Era-1 (4.8%) 相比显著更高,主要是由固体瘤驱动的.
在Era-2中,SPM诊断的中位时间较短 (43.5个月与59个月).
在Era-2中观察到血液恶性瘤风险增加 (SIR = 1.71),而SPM患者的生存状况没有显著改善.

结论:

在MM幸存者中,SPM的风险显著增加,特别是在最近的治疗时代.
较短的延迟到SPM发展需要加强MM幸存者的癌症监测策略.
与单独MM相比,SPM患者的生存益处受到幸存者偏差的影响.

关键词:

累积发生率是累积发生率.多发性骨髓瘤是多发性骨髓瘤的一种.预后预后预后第二种主要恶性瘤.这是治疗时代的治疗时代.

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