Department of Hematology, First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
Leuk Lymphoma. 2011 Feb;52(2):260-4. doi: 10.3109/10428194.2010.538775. Epub 2010 Dec 6.
Multiple myeloma (MM) is characterized by complex genetic and chromosomal abnormalities involving both numerical and structural aberrations, which have clinical prognostic value. The plasma cell labeling index (PCLI) is one of the most important prognostic factors in newly diagnosed MM, and indicates plasma cell proliferative capacity. In this study, we determined the PCLI and the deletion of 13q14, retinoblastoma-1 gene (RB-1), 1p13, and 17p13, 1q21 amplification, and IgH rearrangements in 42 newly diagnosed patients with MM. A high PCLI was observed in 18 patients (42.9%), and the del(13q14) was present in 25 patients (59.5%), del(RB-1) in 23 patients (54.8%), del(17p13) in eight patients (19.1%), amp(1q21) in 23 patients (54.7%), del(1p13) in 17 patients (40.5%), and IgH rearrangements in 28 patients (66.7%). We further detected the IgH translocation partners: t(11;14)(q13;q32), t(4;14)(p16;q32), and t(14;16)(q32;q23) in 19, 15, and five patients, respectively. The PCLI had a significant correlation with del(13q14) (p = 0.006), but no correlation with other chromosome abnormalities or clinical and laboratory features (p > 0.05). The PCLI was higher among patients with del(13q14), and patients with a high PCLI had a short time to disease progression. In conclusion, PCLI is a powerful and independent prognostic parameter in newly diagnosed MM, and correlates with del(13q14).
多发性骨髓瘤(MM)的特征是涉及数字和结构异常的复杂遗传和染色体异常,这些异常具有临床预后价值。浆细胞标记指数(PCLI)是新诊断的 MM 中最重要的预后因素之一,它表示浆细胞的增殖能力。在本研究中,我们测定了 42 例新诊断的 MM 患者的 PCLI 以及 13q14 缺失、视网膜母细胞瘤-1 基因(RB-1)缺失、1p13 缺失、17p13 缺失、1q21 扩增和 IgH 重排。18 例患者(42.9%)存在高 PCLI,25 例患者(59.5%)存在 13q14 缺失,23 例患者(54.8%)存在 RB-1 缺失,8 例患者(19.1%)存在 17p13 缺失,23 例患者(54.7%)存在 1q21 扩增,17 例患者(40.5%)存在 1p13 缺失,28 例患者(66.7%)存在 IgH 重排。我们进一步检测了 19 例、15 例和 5 例患者的 IgH 易位伙伴:t(11;14)(q13;q32)、t(4;14)(p16;q32)和 t(14;16)(q32;q23)。PCLI 与 13q14 缺失(p=0.006)显著相关,但与其他染色体异常或临床和实验室特征无相关性(p>0.05)。13q14 缺失的患者中 PCLI 较高,且 PCLI 较高的患者疾病进展时间较短。综上所述,PCLI 是新诊断的 MM 中一个强大的独立预后参数,与 13q14 缺失相关。