Liu Nian, Zhou Hebing, Yang Guangzhong, Geng Chuanying, Jian Yuan, Guo Huan, Chen Wenming
Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China.
Oncol Lett. 2015 Feb;9(2):930-936. doi: 10.3892/ol.2014.2750. Epub 2014 Dec 1.
Genetic abnormalities in patients with multiple myeloma (MM) are important risk factors in terms of prognosis. In the present study, the prognostic value of several common MM genetic abnormalities was investigated. Interphase fluorescence hybridization (iFISH) was used to detect genetic abnormalities, including 1q21 gain, t(4;14), t(11;14), t(14;16) and 17p13 deletion in 131 patients. A total of 46.6% patients were detected with one or more abnormalities using iFISH analysis. The 1q21 gain, t(4;14), t(11;14), t(14;16) and 17p13 deletion abnormalities were detected in 42.5, 6.9, 17.5, 0.8 and 10.7% of patients, respectively. Patients with t(4;14) commonly exhibited lower levels of albumin and hemoglobin. The progression-free survival (PFS) and overall survival times of iFISH-positive patients (particularly patients with two or more iFISH abnormalities) were significantly shorter than those of the patients without detectable abnormalities. The 1q21 gain and 17p13 deletion were also adverse prognostic factors for MM. Bortezomib-based therapies improved the PFS times in the patients with unfavorable iFISH abnormalities. These findings demonstrate that patients with two or more iFISH abnormalities, a gain of the 1q21 region or a 17p13 deletion were more likely to have a poor prognosis; however, bortezomib treatment improved the outcome for MM patients with unfavorable iFISH abnormalities.
多发性骨髓瘤(MM)患者的基因异常是影响预后的重要风险因素。在本研究中,对几种常见的MM基因异常的预后价值进行了调查。采用间期荧光原位杂交(iFISH)技术检测131例患者的基因异常,包括1q21扩增、t(4;14)、t(11;14)、t(14;16)和17p13缺失。iFISH分析显示,共有46.6%的患者检测到一种或多种异常。1q21扩增、t(4;14)、t(11;14)、t(14;16)和17p13缺失异常的检出率分别为42.5%、6.9%、17.5%、0.8%和10.7%。t(4;14)患者的白蛋白和血红蛋白水平通常较低。iFISH阳性患者(尤其是有两种或更多iFISH异常的患者)的无进展生存期(PFS)和总生存期明显短于未检测到异常的患者。1q21扩增和17p13缺失也是MM的不良预后因素。基于硼替佐米的治疗改善了iFISH异常不利患者的PFS时间。这些发现表明,有两种或更多iFISH异常、1q21区域扩增或17p13缺失的患者预后较差;然而,硼替佐米治疗改善了iFISH异常不利的MM患者的预后。