Mitoxantrone in Multiple Sclerosis: Malignancy Risk Higher Than Previously Appreciated

Several studies have found the incidence of acute myeloid leukemia (AML) after mitoxantrone use is about 0.8%. Mitoxantrone continues to be used as induction therapy and for progressive multiple sclerosis (MS). Therefore, researchers at an MS center in Germany examined malignancy outcomes in 676 patients treated with mitoxantrone with a minimal follow-up of 3 years.

The authors identified 37 patients (5.5%) with confirmed malignancy diagnosed during follow-up, including breast cancer (n=9); colorectal cancer (n=7); AML (n=4); 2 each of glioblastoma multiforme, lung cancer, pancreatic cancer, and prostate cancer; and 1 each of nine other malignancy types. Median time to AML diagnosis from mitoxantrone initiation was 35 months. There were 12 d…