背景:1q21的增益/扩增(amp)是多发性骨髓瘤(MM)中最常见的高危染色体异常(HRCA)之一。1q21的预后价值在增益或放大器的状态以及其他HRCA的组合方面仍存在争议。
方法:在这项回顾性研究中,我们纳入了318例新诊断的MM(NDMM)患者,这些患者有荧光原位杂交(FISH)数据,并在我们科室接受了新型药物治疗.
结果:我们的研究指出,患有amp1q21的MM患者更可能伴有t(4;14),t(14;16),和t(14;20)。amp1q21患者年龄较大,高级修订的国际分期系统(R-ISS)阶段,贫血,与单独获得1q21和无1q21的患者相比,骨髓中的浆细胞更多。此外,单独使用amp1q21与较短的无进展生存期(PFS)相关(22.8mvs.40.5mvs.39.6m)和总生存率(OS)(45.2mvs.NAvs.83.5m)与单独获得1q21且无FISH异常相比。尽管在患有amp1q21的患者中使用的蛋白酶体抑制剂和免疫调节药物的比例很高,但与没有1q21和获得1q21相比,总体反应(ORR)最低。多因素分析将amp1q21定义为NDMM患者的独立预后指标,而不是获得1q21。
结论:amp1q21预测治疗反应和生存率较差,尤其是与高危IgH易位共存。
BACKGROUND: The gain/amplification (amp) of 1q21 is one of the most common high-risk chromosome abnormality (HRCA) in multiple myeloma (MM). The prognostic value of 1q21+ remains to be controversial on the status of gain or amp and the combination of other HRCAs.
METHODS: In this retrospective study, we included 318 newly diagnosed MM (NDMM) patients who had fluorescence in situ hybridization (FISH) data and treated with novel agents in our department.
RESULTS: Our study noted MM patients with amp 1q21 were more likely accompanied with t(4;14), t(14;16), and t(14;20). Patients with amp 1q21 presented with elder age, advanced Revised International Staging System (R-ISS) stages, anemia, and more plasma cells in bone marrow compared to patients with gain 1q21 alone and no 1q21+. Moreover, amp 1q21 alone correlated with shorter progression-free survival (PFS) (22.8m vs. 40.5m vs. 39.6m) and overall survival (OS) (45.2m vs. NA vs. 83.5m) compared with gain 1q21 alone and no FISH abnormalities. Although the high ratio of proteasome inhibitor and immunomodulatory drugs used in patients with amp 1q21, the overall response (ORR) was the lowest compared with no 1q21+ and gain 1q21. Multivariate analysis defined amp 1q21 as an independent prognostic marker for NDMM patients, rather than gain 1q21.
CONCLUSIONS: The amp 1q21 predict inferior treatment response and survival, especially coexisted with high-risk IgH translocation.