Flow chart and distribution of additional malignancies. (A) Flow chart. (B) Multiple primary cancers in TI patients with NDMM (n = 360). With a median follow-up of 42 months (95% CI, 40-44), 35 of 360 (9.7%) patients had a diagnosis of AdMs after MM diagnosis, including 16 SyMs and 19 SPMs. Of the 174 patients treated up front with Len-based regimens, 12 (6.9%) had an SPM.