Gutiérrez Norma C, García Juan L, Hernández Jesús M, Lumbreras Eva, Castellanos Mariana, Rasillo Ana, Mateo Gema, Hernández José M, Pérez Sonia, Orfao Alberto, San Miguel Jesús F
Servicio de Hematología, Hospital Universitario de Salamanca, Paseo San Vicente 58-182, 37007 Salamanca, Spain.
Blood. 2004 Nov 1;104(9):2661-6. doi: 10.1182/blood-2004-04-1319. Epub 2004 Jul 6.
Cytogenetic abnormalities, evaluated either by karyotype or by fluorescence in situ hybridization (FISH), are considered the most important prognostic factor in multiple myeloma (MM). However, there is no information about the prognostic impact of genomic changes detected by comparative genomic hybridization (CGH). We have analyzed the frequency and prognostic impact of genetic changes as detected by CGH and evaluated the relationship between these chromosomal imbalances and IGH translocation, analyzed by FISH, in 74 patients with newly diagnosed MM. Genomic changes were identified in 51 (69%) of the 74 MM patients. The most recurrent abnormalities among the cases with genomic changes were gains on chromosome regions 1q (45%), 5q (24%), 9q (24%), 11q (22%), 15q (22%), 3q (16%), and 7q (14%), while losses mainly involved chromosomes 13 (39%), 16q (18%), 6q (10%), and 8p (10%). Remarkably, the 6 patients with gains on 11q had IGH translocations. Multivariate analysis selected chromosomal losses, 11q gains, age, and type of treatment (conventional chemotherapy vs autologous transplantation) as independent parameters for predicting survival. Genomic losses retained the prognostic value irrespective of treatment approach. According to these results, losses of chromosomal material evaluated by CGH represent a powerful prognostic factor in MM patients.
通过核型分析或荧光原位杂交(FISH)评估的细胞遗传学异常,被认为是多发性骨髓瘤(MM)最重要的预后因素。然而,关于比较基因组杂交(CGH)检测到的基因组变化的预后影响尚无相关信息。我们分析了74例新诊断MM患者中CGH检测到的基因变化的频率和预后影响,并评估了这些染色体失衡与FISH分析的IGH易位之间的关系。74例MM患者中有51例(69%)发现了基因组变化。基因组变化病例中最常见的异常是1q(45%)、5q(24%)、9q(24%)、11q(22%)、15q(22%)、3q(16%)和7q(14%)染色体区域的增益,而缺失主要涉及13号(39%)、16q(18%)、6q(10%)和8p(10%)染色体。值得注意的是,11q增益的6例患者存在IGH易位。多变量分析选择染色体缺失、11q增益、年龄和治疗类型(传统化疗与自体移植)作为预测生存的独立参数。无论治疗方法如何,基因组缺失都保留了预后价值。根据这些结果,CGH评估的染色体物质缺失是MM患者的一个有力预后因素。