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对处于诊断和进展/复发两个不同阶段的多发性骨髓瘤患者8号染色体畸变的分子细胞遗传学分析。

Molecular Cytogenetic Analysis of Chromosome 8 Aberrations in Patients With Multiple Myeloma Examined in 2 Different Stages, at Diagnosis and at Progression/Relapse.

作者信息

Mlynarcikova Miroslava, Balcarkova Jana, Mickova Pavla, Scudla Vlastimil, Pika Tomas, Bacovsky Jaroslav, Minarik Jiri, Janousova Eva, Jarosova Marie

机构信息

Department of Hemato-oncology, Palacky University Hospital, Olomouc, Czech Republic.

Institute of Biostatistics and Analysis, Masaryk University, Brno, Czech Republic.

出版信息

Clin Lymphoma Myeloma Leuk. 2016 Jun;16(6):358-65. doi: 10.1016/j.clml.2016.02.038. Epub 2016 Feb 27.

Abstract

BACKGROUND

The genome of multiple myeloma (MM) clonal plasma cells is characterized by genetic changes of prognostic importance. Disease progression is accompanied by a number of secondary chromosomal aberrations including chromosome 8. We focused on the detection of chromosome 8 aberrations in patients with MM who were examined at 2 different phases: diagnosis and progression/relapse.

PATIENTS AND METHODS

A total of 62 patients with MM were examined at the time of diagnosis and at relapse/progression. The median age was 64 years (range, 39-78 years); the study included 29 males and 33 females. We analyzed bone marrow samples for detecting aberrations on chromosome 8 by the fluorescence immunophenotyping and interphase cytogenetics as a tool for the investigation of neoplasms (FICTION) and fluorescence in situ hybridization methods with specific probes.

RESULTS

Chromosome 8 aberrations were detected in 24 (38.7%) patients at diagnosis and in 29 (46.8%) patients at progression/relapse. Only 5 (8%) patients developed additional chromosome 8 changes at progression/relapse. The aberrations were heterogeneous, involving numerical and structural changes of the MYC gene. Aberrations of the short arm of chromosome 8, involving the genes TRAIL-R1/-R2, were less frequent (4 of 62 patients, 6.4%). All aberrations of chromosome 8 were accompanied with additional changes and with an advanced clinical phase of the disease. This finding significantly influenced the overall survival of patients.

CONCLUSION

In the current study, chromosome 8 aberrations were highly heterogeneous, were presented at diagnosis in patients with advanced clinical stage, and were associated with worse overall survival. We have not confirmed the increase of frequency aberration of chromosome 8 in disease progression. The findings demonstrate the importance of fluorescence in situ hybridization examination of chromosome 8 in newly diagnosed patients with MM.

摘要

背景

多发性骨髓瘤(MM)克隆性浆细胞的基因组具有具有预后重要性的基因改变特征。疾病进展伴随着许多继发性染色体畸变,包括8号染色体。我们重点关注在两个不同阶段接受检查的MM患者中8号染色体畸变的检测:诊断时和进展/复发时。

患者和方法

共有62例MM患者在诊断时以及复发/进展时接受了检查。中位年龄为64岁(范围39 - 78岁);该研究包括29名男性和33名女性。我们通过荧光免疫表型分析和间期细胞遗传学(作为肿瘤研究工具的荧光免疫表型和间期细胞遗传学分析,FICTION)以及使用特异性探针的荧光原位杂交方法分析骨髓样本,以检测8号染色体上的畸变。

结果

在诊断时,24例(38.7%)患者检测到8号染色体畸变,在进展/复发时,29例(46.8%)患者检测到8号染色体畸变。只有5例(8%)患者在进展/复发时出现了额外的8号染色体改变。这些畸变是异质性的,涉及MYC基因的数量和结构变化。8号染色体短臂的畸变,涉及TRAIL - R1 / - R2基因,较少见(62例患者中有4例,6.4%)。所有8号染色体畸变都伴有其他改变以及疾病的晚期临床阶段。这一发现显著影响了患者的总生存期。

结论

在本研究中,8号染色体畸变高度异质性,在临床晚期患者的诊断时出现,并与较差的总生存期相关。我们未证实疾病进展时8号染色体畸变频率增加。这些发现证明了对新诊断的MM患者进行8号染色体荧光原位杂交检查的重要性。

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