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Title: [Prognostic factors in newly diagnosed multiple myeloma patients with 1q21 amplification/gain treated with bortezomib-based regimens followed by autologous hematopoietic stem cell transplantation].
Author: Huang WY, Zou DH, Liu W, An G, Xu Y, Sui WW, Deng SH, Li CW, Liu H, Li J, Qiu LG.
Journal: Zhonghua Xue Ye Xue Za Zhi; 2018 Jun 14; 39(6):496-500. PubMed ID: 30032568.
Abstract:
Objective: To explore the prognostic factors in newly diagnosed multiple myeloma (NDMM) patients with 1q21 amplification/gain treated with bortezomib-based regimens followed by autologous hematopoietic stem cell transplantation (ASCT) . Methods: We retrospectively assayed 35 NDMM patients with 1q21 amplification/gain who received bortezomib-based chemotherapy followed by ASCT and maintenance therapy between January 2008 and August 2015. Results: ①The median age of 35 patients were 49(33-63)years old. Ratio of male to female was 22∶13. Monosomy1q21 amplification/gain was only seen in 3(8.6%) patients, the other 32 patients were with additional cytogenetic abnormalities including 13q14 deletion, t(11,14), t(4,14), t(14,16), 17p deletion and complex karyotype aberrations. ②The complete remission (CR) rate was 57.0% (20/35), the very good partial remission(VGPR) rate was 37.1%(13/35) and the partial remission (PR) rate was 5.7%(2/35) after ASCT. At a median follow-up of 24 (8-85) months, 3-year estimated progression free survival (PFS) and overall survival (OS) rate were (66.5±9.7)% and (69.6±9.9)%, respectively. ③As 13 patients with high-risk cytogenetic abnormalities, the median PFS and OS time was 26 and 28 months. The 3-year estimated PFS and OS was (28.0±15.9)% and (36.5±16.4)%, respectively. Another 22 patients without other high-risk cytogenetic abnormalities, the median PFS and OS time was 54 months and not reached. The 3-year estimated PFS and OS was (71.5±12.7)% and (92.3±7.4)% in this group, respectively. The presence of additional other high-risk cytogenetic abnormalities resulted in significantly shortened PFS (χ(2)=5.404, P=0.020) and OS (χ(2)=7.596, P=0.006) compared with no high-risk cytogenetic patients. Conclusion: NDMM patients with isolated1q21 amplification/gain were rarely and usually had additional other cytogenetic abnormalities. The outcomes in this group treated with bortezomib-based chemotherapy followed by ASCT and maintenance therapy were satisfied, additional other high-risk cytogenetic abnormalities made PFS and OS further shortened. 目的： 探讨硼替佐米为基础的化疗序贯自体造血干细胞移植（ASCT）治疗伴有1q21扩增的初治多发性骨髓瘤（MM）患者的疗效和预后影响因素。 方法： 回顾性分析2008年1月至2015年8月以硼替佐米为基础的化疗序贯ASCT以及移植后维持和（或）巩固治疗伴有1q21扩增的35例初治MM患者资料。 结果： ①35例患者中，男22例，女13例，中位发病年龄49（33~63）岁。单纯检出1q21扩增者仅为3例（8.6%），其余32例均合并其他细胞遗传学异常，包括13q14缺失、t（11;14）、t（4;14）、t（14;16）、17p缺失和复杂核型。②ASCT后获得完全缓解者20例（57.0%），获得非常好的部分缓解者13例（37.1%），获得部分缓解者2例（5.7%）。中位随访24（8~85）个月，预期3年无进展生存（PFS）率和总生存（OS）率分别为（66.5±9.7）%和（69.6±9.9）%。③按合并其他高危或非高危细胞遗传学异常对患者进行分组，高危组（13例）中位PFS和OS时间分别为26个月和28个月，非高危组（22例）中位PFS和OS时间分别为54个月和未达到，高危组与低危组3年预期PFS率[（28.0±15.9）%对（71.5±12.7）%，χ(2)=5.404，P=0.020]和OS率[（36.5±16.4）%对（92.3±7.4）%，χ(2)=7.596，P=0.006]差异均有统计学意义。 结论： 1q21扩增很少单独发生，常伴发其他细胞遗传学异常。硼替佐米为基础的化疗序贯ASCT治疗初治MM患者疗效良好，合并其他高危细胞遗传学异常是影响该亚组患者PFS和OS的不良预后因素。.

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