Department of Hematology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, People's Republic of China.
Department of Hematology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China.
Clin Lymphoma Myeloma Leuk. 2019 Mar;19(3):e159-e164. doi: 10.1016/j.clml.2018.12.002. Epub 2018 Dec 20.
Multiple myeloma (MM) is a heterogeneous disease characterized by chromosomal translocation, deletion, and amplification in plasma cells, resulting in a huge heterogeneity in its outcomes. In the era of novel agents such as bortezomib, thalidomide, and the cycles of treatment, risk stratification by chromosomal aberrations may enable a more rational risk-stratification selection of therapeutic approaches in patients with MM.
We performed a retrospective study in 63 patients with MM; 29 (46.03%) with 1q21 gain and 34 (53.97%) without gain.
In all patients, we did not find that the patients with 1q21 gain had significantly better survival compared with patients without 1q21 gain (overall survival, P = .6916; progression-free survival, P = .8740). However, in 1q21 gain patients, we found that the bortezomib group had significantly better survival compared with the non-bortezomib group in terms of both the 3-year estimated overall survival (82.3% vs. 18.8%; P = .0154) and progression-free survival (62.8% vs. 8.75%; P = .0385).
1q21 gain detected by fluorescence in situ hybridization is not as high risk for poor prognosis with regard to time for overall survival. And the clinical outcome of patients with 1q21 gain can be improved in those who received no less than 4 cycles of bortezomib-based therapy (bortezomib, thalidomide, and dexamethasone).
多发性骨髓瘤（MM）是一种异质性疾病，其特征为浆细胞染色体易位、缺失和扩增，导致其结果存在巨大异质性。在硼替佐米、沙利度胺和治疗周期等新型药物时代，通过染色体异常进行风险分层可能使 MM 患者的治疗方法更合理地进行风险分层选择。
我们对 63 例 MM 患者进行了回顾性研究；其中 29 例（46.03%）存在 1q21 增益，34 例（53.97%）不存在增益。
在所有患者中，我们并未发现 1q21 增益患者的生存情况明显优于无 1q21 增益患者（总生存，P=0.6916；无进展生存，P=0.8740）。然而，在 1q21 增益患者中，我们发现与非硼替佐米组相比，硼替佐米组在 3 年估计总生存率（82.3%比 18.8%；P=0.0154）和无进展生存率（62.8%比 8.75%；P=0.0385）方面的生存情况明显更好。
荧光原位杂交检测到的 1q21 增益在总生存时间方面并不是预后不良的高风险因素。并且，接受不少于 4 个周期硼替佐米为基础治疗（硼替佐米、沙利度胺和地塞米松）的 1q21 增益患者的临床结局可以得到改善。
