Qin Yazhen, Lu Jin, Bao Li, Zhu Honghu, Li Jinlan, Li Lingdi, Lai Yueyun, Shi Hongxia, Wang Yazhe, Liu Yanrong, Jiang Bin, Huang Xiaojun
Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China.
Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China; Peking-Tsinghua Center for Life Sciences, Peking University, Beijing 100871, China. Email:
Chin Med J (Engl). 2014;127(9):1666-71.
Significant efforts have been made to identify factors that differentiate patients treated with novel therapies, such as bortezomib in multiple myeloma (MM). The exact expression pattern and prognostic value of the cancer/testis antigen preferentially expressed antigen of melanoma (PRAME) in MM are unknown and were explored in this study.
The transcript level of PRAME was detected in bone marrow specimens from 100 newly diagnosed MM patients using real-time quantitative polymerase chain reaction, and the prognostic value of PRAME was determined through retrospective survival analysis. PRAME expression higher than the upper limit of normal bone marrow was defined as PRAME overexpression or PRAME (+).
Sixty-two patients (62.0%) overexpressed PRAME. PRAME overexpression showed no prognostic significance to either overall survival (n = 100) or progression-free survival (PFS, n = 96, all P > 0.05) of patients. The patients were also categorized according to regimens with or without bortezomib. PRAME overexpression tended to be associated with a lower two-year PFS rate in patients treated with non-bortezomib-containing regimens (53.5% vs. 76.9%, P = 0.071). By contrast, it was not associated with the two-year PFS rate in patients with bortezomib-containing regimens (77.5% vs. 63.9%, P > 0.05). When the patients were categorized into PRAME (+) and PRAME (-) groups, treatment with bortezomibcontaining regimens predicted a higher two-year PFS rate in PRAME (+) patients (77.5% vs. 53.5%, P = 0.027) but showed no significant effect on two-year PFS rate in PRAME (-) patients (63.9% vs. 76.9%, P > 0.05).
PRAME overexpression might be an adverse prognostic factor of PFS in MM patients treated with non-bortezomib-containing regimens. Bortezomib improves PFS in patients overexpressing PRAME.
人们已付出巨大努力来确定能够区分接受新型疗法（如用于多发性骨髓瘤（MM）的硼替佐米）治疗的患者的因素。黑色素瘤优先表达抗原（PRAME）这种癌/睾丸抗原在MM中的具体表达模式和预后价值尚不清楚，本研究对此进行了探索。
使用实时定量聚合酶链反应检测100例新诊断MM患者骨髓标本中PRAME的转录水平，并通过回顾性生存分析确定PRAME的预后价值。PRAME表达高于正常骨髓上限被定义为PRAME过表达或PRAME（+）。
62例患者（62.0%）PRAME过表达。PRAME过表达对患者的总生存期（n = 100）或无进展生存期（PFS，n = 96，所有P>0.05）均无预后意义。患者还根据是否使用硼替佐米进行了分类。在接受不含硼替佐米方案治疗的患者中，PRAME过表达往往与较低的两年PFS率相关（53.5%对76.9%，P = 0.071）。相比之下，在接受含硼替佐米方案治疗的患者中，它与两年PFS率无关（77.5%对63.9%，P>0.05）。当患者分为PRAME（+）组和PRAME（-）组时，含硼替佐米方案治疗预测PRAME（+）患者有更高的两年PFS率（77.5%对53.5%，P = 0.027），但对PRAME（-）患者的两年PFS率无显著影响（63.9%对76.9%，P > 0.05）。
PRAME过表达可能是接受不含硼替佐米方案治疗的MM患者PFS的不良预后因素。硼替佐米可改善PRAME过表达患者的PFS。
