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Abstract：
High-risk cytogenetic abnormalities (HRCAs) influence the prognosis of multiple myeloma (MM). However, additional cytogenetic aberrations can lead to poor outcomes. This study aimed to clarify whether HRCAs and additional chromosomal abnormalities affect MM prognosis. Patients with newly diagnosed MM who were treated with novel agents were retrospectively evaluated. The primary objective was to assess the difference in progression-free survival (PFS) and overall survival (OS) between patients with/without HRCAs and between patients with/without complex karyotype (CK). The secondary objectives were to identify factors affecting PFS/OS and factors related to CK. HRCAs were defined as del(17p), t(4;14), t(14;16), and gain/amplification(1q) assessed using fluorescence in situ hybridization. CK was defined as ≥3 chromosomal abnormalities on G-banding. Among 110 patients, 40 had HRCAs and 15 had CK. In this study, survival durations between patients with/without HRCAs were similar, while the CK group had significantly poorer PFS/OS than the no-CK group (median PFS: 9 vs. 24 months and median OS: 29 vs. 97 months, respectively), and a poor prognostic impact of CK was maintained in patients with HRCAs. In multivariate analysis, CK was correlated with poor PFS/OS (hazard ratio [HR]: 2.39, 95% confidence interval [95% CI]: 1.22-4.66 and HR: 2.66, 95% CI: 1.10-6.45, respectively). Bone marrow plasma cell (BMPC) ≥60% (odds ratio [OR] = 6.40, 95% CI: 1.50-27.2) and Revised International Staging System III (OR = 7.53, 95% CI: 2.09-27.1) were associated with CK. Our study suggests that CK may contribute to the poor prognosis of MM. Aggressive disease status including high BMPC proliferation could be relevant to CK.
摘要：
高危细胞遗传学异常(HRCAs)影响多发性骨髓瘤(MM)的预后。然而,额外的细胞遗传学异常可能导致不良结局.本研究旨在阐明HRCA和其他染色体异常是否会影响MM的预后。对接受新型药物治疗的新诊断MM患者进行回顾性评估。主要目的是评估有/没有HRCA的患者与有/没有复杂核型（CK）的患者之间的无进展生存期（PFS）和总生存期（OS）的差异。次要目标是确定影响PFS/OS的因素和与CK相关的因素。HRCA定义为del(17p)，t(4;14)，t(14;16)，和使用荧光原位杂交评估的增益/扩增(1q)。CK被定义为G带≥3个染色体异常。110名患者中,40人患有HRCA，15人患有CK。在这项研究中,有/没有HRCA的患者之间的生存持续时间相似，而CK组的PFS/OS明显低于无CK组（中位PFS：9vs.24个月和中位OS：29vs.97个月,分别)，在HRCA患者中，CK对预后的影响仍然较差。在多变量分析中，CK与不良PFS/OS相关（风险比[HR]：2.39，95％置信区间[95％CI]：1.22-4.66和HR：2.66，95％CI：1.10-6.45，分别）。骨髓浆细胞（BMPC）≥60％（比值比[OR]=6.40，95％CI：1.50-27.2）和修订的国际分期系统III（OR=7.53，95％CI：2.09-27.1）与CK相关。我们的研究表明，CK可能导致MM的不良预后。包括高BMPC增殖的侵袭性疾病状态可能与CK有关。
