# Second Primary Malignancy in Ixazomib Maintenance Therapy for Multiple Myeloma: Case Report and Literature Review

## TL;DR

A multiple myeloma patient developed a second cancer after long-term ixazomib treatment, raising concerns about its potential link to secondary malignancies.

## Contribution

This case report highlights a possible association between ixazomib maintenance therapy and second primary malignancies.

## Key findings

- A patient developed MDS after 5 years of ixazomib maintenance therapy.
- The patient was young and lacked cytogenetic data, complicating risk assessment.
- Allo-HSCT was recommended, and the patient remains alive.

## Abstract

With the prolongation of life expectancy among multiple myeloma (MM) patients, the development of second primary malignancies (SPMs) has emerged as a serious issue, so it is worthwhile to explore the mechanisms and therapeutic strategy regarding SPMs secondary to MM.

We describe a patient with MM who developed secondary myelodysplastic syndrome (MDS) after 5 years of maintenance chemotherapy with ixazomib.

In our case, the patient was young and did not have a cytogenetic examination; after a maintenance therapy with ixazomib for about 5 years, he developed the MDS. He was subsequently recommended for allogeneic hematopoietic stem cell transplantation (allo-HSCT) and remains alive.

The possibility of an association between ixazomib maintenance treatment and increased SPMs cannot be excluded, requiring future studies with large samples.