Department of Laboratory Hematology, University Health Network, University of Toronto, Toronto, Canada.
Leuk Res. 2011 Jan;35(1):95-8. doi: 10.1016/j.leukres.2010.05.002. Epub 2010 May 26.
We investigated the influence of genetic risk factors on the clinical response to bortezomib in 85 relapsed/refractory multiple myeloma (MM) patients. Interphase cytoplasmic fluorescence in situ hybridization (cIg-FISH) detected del(13q), del(17p), del(1p21), t(4;14), and 1q21 gain in 38%, 22%, 26%, 18% and 39% of evaluable cases. Forty-nine patients (49%) responded to bortezomib with median progression free (PFS) and overall survivals (OS) of 5.0 and 12.6 months, respectively. Patients with 1q21 gain had a significantly shorter OS (5.3 months vs. 24.6 months, p=0.0006) and PFS (2.3 months vs. 7.3 months, p=0.003) than patients without such abnormality. There was no significant difference in response rate, response duration, PFS or OS for any of the other genetic risk factors tested. Multivariate analysis confirmed that 1q21 gain is an independent risk factor for PFS (p=0.03) and OS (p=0.009) of bortezomib-treated relapsed/refractory myeloma.
我们研究了遗传风险因素对 85 例复发/难治性多发性骨髓瘤（MM）患者硼替佐米临床反应的影响。间期细胞质荧光原位杂交（cIg-FISH）检测到 38%、22%、26%、18%和 39%的可评估病例中存在 del(13q)、del(17p)、del(1p21)、t(4;14)和 1q21 增益。49 例（49%）患者对硼替佐米有反应，中位无进展生存期（PFS）和总生存期（OS）分别为 5.0 个月和 12.6 个月。1q21 增益患者的 OS（5.3 个月 vs. 24.6 个月，p=0.0006）和 PFS（2.3 个月 vs. 7.3 个月，p=0.003）明显短于无此异常的患者。对于所测试的任何其他遗传风险因素，反应率、反应持续时间、PFS 或 OS 均无显著差异。多变量分析证实，1q21 增益是硼替佐米治疗复发/难治性骨髓瘤患者 PFS（p=0.03）和 OS（p=0.009）的独立危险因素。
