多发性骨髓瘤（MM）患者患有二次原发性恶性肿瘤（SMPs）的风险增加。本跨国级“真实世界”回顾性研究分析了患有SMPs的MM患者的特征和结果。共分析了165名患者：男性占62.4％；有先前癌症病史者占8.5％；其中113名患者出现实体SMPs，主要为≥2期；52名患者出现血液系统SMP（血液-SPM），主要为MDS/AML。血液-SPM患者年龄较轻（p = 0.05），先前进行过自体干细胞移植（p = 0.012）的频率较高。年龄较大（>65岁）且接受过更多治疗的患者发生SMP的时间较短。在SPM检测时有100名患者正在接受积极治疗。52名患者停止治疗，15名患者替换其他抗MM疗法，33名患者继续进行治疗。停止治疗在被诊断为血液-SPM的患者中占主导地位（76％）。SPM检测后的中位生存时间为8.5个月，死亡的主要原因是SPM。恶劣的ECOG状态预示着较短的生存时间（PS 3 对比 0，HR = 5.74，2.32-14.21，p < 0.001），而血红蛋白正常水平的预测值HR = 0.43，0.19-0.95，p = 0.037）预示着较长的生存时间。随着生存时间的持续改善，更多MM患者可能会出现SPM。SPM诊断后的生存时间较短，因此，频繁的监测和早期检测对改善结局至关重要。

There is an increased risk of second primary malignancies (SMPs) in patients with multiple myeloma (MM). This multinational 'real-world' retrospective study analyzed the characteristics and outcomes of MM patients that developed SPMs.165 patients were analyzed: 62.4% males; 8.5% with a prior cancer; 113 with solid SPMs, mainly ≥stage 2; and 52 with hematological SPM (hemato-SPM), mainly MDS/AML. Patients with hemato-SPM were younger (p = 0.05) and more frequently had a prior AutoHCT (p = 0.012). The time to SPM was shorter in the older (>65 years) and more heavily pretreated patients. One hundred patients were actively treated at the time of SPM detection. Treatment was discontinued in 52, substituted with another anti-MM therapy in 15, and continued in 33 patients. Treatment discontinuation was predominant in the patients diagnosed with hemato-SPM (76%). The median OS following SPM detection was 8.5 months, and the main cause of death was SPM. A poor ECOG status predicted a shorter OS (PS 3 vs. 0, HR = 5.74, 2.32-14.21, p < 0.001), whereas a normal hemoglobin level (HR = 0.43, 0.19-0.95, p = 0.037) predicted longer OS.With the continuing improvement in OS, a higher proportion of MM patients might develop SPM. The OS following SPM diagnosis is poor; hence, frequent surveillance and early detection are imperative to improve outcomes.