Unité de Génomique du Myélome, University Hospital, CRCT, INSERM U 1037, Université Paul Sabatier, Toulouse, France.
Service des Maladies du Sang, Hopital Claude Huriez, CHRU, Lille, France.
Leukemia. 2014 Mar;28(3):675-9. doi: 10.1038/leu.2013.225. Epub 2013 Jul 29.
Deletions of the 1p region appear as a pejorative prognostic factor in multiple myeloma patients (especially 1p22 and 1p32 deletions) but there is a lack of data on the real impact of 1p abnormalities on an important and homogeneous group of patients. To address this issue we studied by fluorescence in situ hybridization (FISH) the incidence and prognostic impact of 1p22 and 1p32 deletions in 1195 patients from the IFM (Institut Francophone du Myélome) cell collection. Chromosome 1p deletions were present in 23.3% of the patients (271): 15.1% (176) for 1p22 and 7.3% (85) for 1p32 regions. In univariate analyses, 1p22 and 1p32 appeared as negative prognostic factors for progression-free survival (PFS): 1p22: 19.8 months vs 33.6 months (P<0.001) and 1p32: 14.4 months vs 33.6 months (P<0.001); and overall survival (OS): 1p22: 44.2 months vs 96.8 months (P=0.002) and 1p32: 26.7 months vs 96.8 months (P<0.001). In multivariate analyses, 1p22 and 1p32 deletions still appear as independent negative prognostic factors for PFS and OS. In conclusion, our data show that 1p22 and 1p32 deletions are major negative prognostic factors for PFS and OS for patients with MM. We thus suggest that 1p32 deletion should be tested for all patients at diagnosis.
1p 区域缺失在多发性骨髓瘤患者中表现为预后不良的因素(尤其是 1p22 和 1p32 缺失),但对于 1p 异常对一组重要且同质的患者的实际影响,数据仍缺乏。为了研究这一问题,我们采用荧光原位杂交(FISH)技术,对 IFM(法语骨髓瘤学会)细胞库的 1195 例患者的 1p22 和 1p32 缺失的发生率和预后影响进行了研究。1p 染色体缺失存在于 23.3%的患者(271 例)中:1p22 缺失占 15.1%(176 例),1p32 缺失占 7.3%(85 例)。在单因素分析中,1p22 和 1p32 缺失被认为是无进展生存期(PFS)的不良预后因素:1p22:19.8 个月 vs 33.6 个月(P<0.001)和 1p32:14.4 个月 vs 33.6 个月(P<0.001);总生存期(OS):1p22:44.2 个月 vs 96.8 个月(P=0.002)和 1p32:26.7 个月 vs 96.8 个月(P<0.001)。在多因素分析中,1p22 和 1p32 缺失仍然是 PFS 和 OS 的独立不良预后因素。总之,我们的数据表明,1p22 和 1p32 缺失是 MM 患者 PFS 和 OS 的主要不良预后因素。因此,我们建议所有患者在诊断时都应检测 1p32 缺失。