Li Fei, Xu Yan, Deng Ping, Yang Ye, Sui Weiwei, Jin Fengyan, Hao Mu, Li Zengjun, Zang Meirong, Zhou Dehui, Gu Zhimin, Ru Kun, Wang Jianxiang, Cheng Tao, Qiu Lugui
State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China.
Department of Hematology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
Oncotarget. 2015 Apr 20;6(11):9434-44. doi: 10.18632/oncotarget.3319.
The deletion of 12p (del(12p)) has been described as a novel negative prognostic marker in multiple myeloma (MM) and has gained increasing attention in recent years. However, its impact on MM is still controversial. In this study, we comprehensively evaluated the clinical impact of 12p13 deletion using fluorescence in situ hybridization (FISH) on 275 newly diagnosed MM cases treated in a prospective, non-randomized clinical trial (BDH 2008/02). The results showed that deletion of 12p13 was detected in 10.5% of newly diagnosed cases and associated with multiple indicators for high tumor burden including ISS III, BM plasmacytosis larger than 50%, and renal lesion. Moreover, the cases with 12p13 deletion typically had higher incidence of del(17p), IGH translocation and t(4;14). Patients with del(12p) conferred significantly adverse prognosis for PFS and OS, even in patients subjected to bortezomib-based therapy. When adjusted to the established prognostic variables including del(13q), del(17p), t(4;14), amp(1q21), ISS stage and LDH, del(12p13) remained the powerful independent adverse factor for PFS (P = 0.007) and OS (P = 0.032). In addition, del(12p13) combined with high β2-MG, high LDH and bone lesion can further identify subpopulations with high-risk features. Our results strongly supported that del(12p13) can be used as a valuable prognostic marker in MM.
12号染色体短臂缺失(del(12p))已被描述为多发性骨髓瘤(MM)中一种新的不良预后标志物,近年来受到越来越多的关注。然而,其对MM的影响仍存在争议。在本研究中,我们使用荧光原位杂交(FISH)对275例新诊断的MM病例进行了前瞻性、非随机临床试验(BDH 2008/02),全面评估了12p13缺失的临床影响。结果显示,10.5%的新诊断病例检测到12p13缺失,且与多种高肿瘤负荷指标相关,包括国际分期系统(ISS)III期、骨髓浆细胞增多大于50%以及肾脏病变。此外,12p13缺失的病例通常有更高的17p缺失、免疫球蛋白重链(IGH)易位和t(4;14)发生率。即使在接受硼替佐米治疗的患者中,12p缺失的患者无进展生存期(PFS)和总生存期(OS)的预后也明显较差。当调整为已确定的预后变量,包括13q缺失、17p缺失、t(4;14)、1q21扩增、ISS分期和乳酸脱氢酶(LDH)时,12p13缺失仍然是PFS(P = 0.007)和OS(P = 0.032)的有力独立不良因素。此外,12p13缺失与高β2-微球蛋白、高LDH和骨病变相结合可进一步识别具有高危特征的亚群。我们的结果有力支持12p13缺失可作为MM中有价值的预后标志物。