**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Efstathios Kastritis, MD 
Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

**Main Body of the Abstract**
Background: Data on the incidence and risk factors for second malignancies are not available for patients with AL amyloidosis.
Aim: to describe the incidence and risk factors for the development of second malignancies among patients with AL amyloidosis.
Methods: The study included 417 consecutive patients, from the Department of Clinical Therapeutics, Athens. The analysis accounted for death due to AL and diagnosis of 2ndmalignancy as competing events.
Results: median age was 65 years, 56% were females; heart and kidneys were involved in 76% and 65%; 16%, 44% and 40% were Mayo stage -1, -2 and -3. Treatment, across all lines, included bortezomib(95%), alkylators(75%) (mostly cyclophosphamide, melphalan in 21%, 5% high dose), lenalidomide(36%) and daratumumab(31%). Median follow-up was 5 years. A second malignancy, after AL diagnosis, occurred in 26(6.2%) patients (solid tumors:23, hematologic:3 patients). The 5- and 10-year cumulative incidence of 2nd malignancy was 5.4% and 10.25%(figure). The 5-year cumulative probability was 8.9% in stage-1 patients (vs 10.5% for death), 5.4% for stage-2 (vs 50.2% for death) and 3.7% for stage-3 (vs 69.7% for death). There was no increased risk associated with the use of alkylators (neither cyclophosphamide or melphalan), lenalidomide or daratumumab. The 2nd cancer was the cause of death in 10/26(38%) of affected patients.
Conclusion: second primary malignancies occur in ~6% of AL patients; among those with low cardiac risk, who also have the longest survival, the 5-year cumulative risk was ~9%. We did not find a significant correlation with the use of alkylators or other treatments.



**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Efstathios Kastritis, MD 
Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

**Main Body of the Abstract**
**Background**: Data on the incidence and risk factors for second malignancies are not available for patients with AL amyloidosis.
**Aim**: to describe the incidence and risk factors for the development of second malignancies among patients with AL amyloidosis.
**Methods**: The study included 417 consecutive patients, from the Department of Clinical Therapeutics, Athens. The analysis accounted for death due to AL and diagnosis of 2ndmalignancy as competing events.
**Results**: median age was 65 years, 56% were females; heart and kidneys were involved in 76% and 65%; 16%, 44% and 40% were Mayo stage -1, -2 and -3. Treatment, across all lines, included bortezomib(95%), alkylators(75%) (mostly cyclophosphamide, melphalan in 21%, 5% high dose), lenalidomide(36%) and daratumumab(31%). Median follow-up was 5 years. A second malignancy, after AL diagnosis, occurred in 26(6.2%) patients (solid tumors:23, hematologic:3 patients). The 5- and 10-year cumulative incidence of 2nd malignancy was 5.4% and 10.25%(figure). The 5-year cumulative probability was 8.9% in stage-1 patients (vs 10.5% for death), 5.4% for stage-2 (vs 50.2% for death) and 3.7% for stage-3 (vs 69.7% for death). There was no increased risk associated with the use of alkylators (neither cyclophosphamide or melphalan), lenalidomide or daratumumab. The 2nd cancer was the cause of death in 10/26(38%) of affected patients.
**Conclusion**: second primary malignancies occur in ~6% of AL patients; among those with low cardiac risk, who also have the longest survival, the 5-year cumulative risk was ~9%. We did not find a significant correlation with the use of alkylators or other treatments.



Incidence of Second Primary Malignancies in Patients with AL amyloidosis and The Impact of Disease Stage and Therapies PA108 (#95)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.