Grzasko Norbert, Hajek Roman, Hus Marek, Chocholska Sylwia, Morawska Marta, Giannopoulos Krzysztof, Czarnocki Krzysztof, Druzd-Sitek Agnieszka, Pienkowska-Grela Barbara, Rygier Jolanta, Usnarska-Zubkiewicz Lidia, Dytfeld Dominik, Kubicki Tadeusz, Jurczyszyn Artur, Korpysz Maciej, Dmoszynska Anna
a Department of Hematology , St. John's Cancer Center , Lublin , Poland.
b Department of Experimental Hematooncology , Medical University of Lublin , Lublin , Poland.
Leuk Lymphoma. 2017 Sep;58(9):1-15. doi: 10.1080/10428194.2016.1272684. Epub 2017 Jan 16.
The study aimed to assess prognostic significance of del(13q14), del(17p13), t(4;14)(p16;q32), and amp(1q21) in newly diagnosed myeloma patients treated mostly with thalidomide-based therapies. All genetic abnormalities except del(13q14) were independent prognostic factors associated with shortened progression-free survival (PFS) and overall survival (OS). Patients with no abnormalities, one abnormality, and ≥2 abnormalities had a median PFS of 41.8, 17.0, and 10.0 months, respectively; a median OS was not reached, 48.0 and 23.3 months, respectively. According to the presence of amp(1q21), t(4;14)(p16;q32), and del(17p13) and the International Staging System (ISS), we stratified patients into low-risk, intermediate-risk and high-risk groups. A median PFS was 52.9, 25.6, and 10.0 months, respectively; a median OS was not reached, 64.0 and 25.0 months, respectively. In conclusion, our study confirmed the prognostic value of cytogenetic changes and showed that prognostic models based on ISS and cytogenetic studies should include not only del(17p13) and t(4;14)(p16;q32), but also amp(1q21).
该研究旨在评估del(13q14)、del(17p13)、t(4;14)(p16;q32)和amp(1q21)在主要接受基于沙利度胺疗法治疗的新诊断骨髓瘤患者中的预后意义。除del(13q14)外,所有基因异常均为独立的预后因素,与无进展生存期(PFS)缩短和总生存期(OS)相关。无异常、有一项异常和≥2项异常的患者的中位PFS分别为41.8、17.0和10.0个月;中位OS分别未达到、48.0和23.3个月。根据amp(1q21)、t(4;14)(p16;q32)和del(17p13)的存在情况以及国际分期系统(ISS),我们将患者分为低风险、中风险和高风险组。中位PFS分别为52.9、25.6和10.0个月;中位OS分别未达到、64.0和25.0个月。总之,我们的研究证实了细胞遗传学改变的预后价值,并表明基于ISS和细胞遗传学研究的预后模型不仅应包括del(17p13)和t(4;14)(p16;q32),还应包括amp(1q21)。