Sagaster V, Kaufmann H, Odelga V, Ackermann J, Gisslinger H, Rabitsch W, Zojer N, Ludwig H, Nösslinger T, Zielinski C, Drach J
Department of Internal Medicine I, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria.
Eur J Haematol. 2007 Mar;78(3):227-34. doi: 10.1111/j.1600-0609.2006.00807.x. Epub 2007 Jan 23.
Little is known about tumor-related prognostic factors, in particular specific chromosomal abnormalities, in young patients with multiple myeloma (MM). We therefore investigated the chromosomal pattern by interphase fluorescence in situ hybridization (chromosomes 13q14, 14q32-translocations, chromosomes associated with hyperdiploidy) in 38 young patients with MM (age <45 yr) and compared the results with those observed in 69 patients with intermediate age (45-70 yr) and 64 elderly patients (age >70 yr). All chromosomal patterns were not significantly different between the three age cohorts. Similarly, standard MM parameters were equally distributed between these MM patient populations. However, survival by the International Staging System (ISS) for MM revealed marked differences between stage I/II (median survival not yet reached) and stage III (23.4 months; P < 0.0003) among young MM patients. A significant survival difference between ISS-stage I/II and ISS-stage III patients was also noted in the intermediate age group (median 65.4 months vs. 24.6 months; P = 0.0009). However, this difference disappeared among elderly MM patients (39.6 months in ISS-stage I/II vs. 32 months in ISS-stage III patients; P = 0.94), but it was unrelated to the cytogenetic pattern. Our results indicate that MM in young patients does not represent a distinct biologic entity, and that short survival of younger MM patients at ISS-stage III is independent of the molecular cytogenetic pattern.
对于年轻的多发性骨髓瘤(MM)患者,人们对肿瘤相关的预后因素,尤其是特定的染色体异常知之甚少。因此,我们通过间期荧光原位杂交技术(检测13q14染色体、14q32易位、与超二倍体相关的染色体)对38例年轻MM患者(年龄<45岁)的染色体模式进行了研究,并将结果与69例中年患者(45 - 70岁)和64例老年患者(年龄>70岁)的结果进行了比较。三个年龄组之间的所有染色体模式均无显著差异。同样,标准的MM参数在这些MM患者群体中分布均匀。然而,国际骨髓瘤分期系统(ISS)显示,年轻MM患者的I/II期(中位生存期尚未达到)和III期(23.4个月;P<0.0003)之间的生存期存在显著差异。在中年组中,ISS - I/II期和ISS - III期患者之间也存在显著的生存差异(中位生存期分别为65.4个月和24.6个月;P = 0.0009)。然而,在老年MM患者中这种差异消失了(ISS - I/II期为39.6个月,ISS - III期为32个月;P = 0.94),且与细胞遗传学模式无关。我们的结果表明,年轻患者的MM并不代表一个独特的生物学实体,并且年轻MM患者在ISS - III期的短生存期与分子细胞遗传学模式无关。