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初发性 del(17p)多发性骨髓瘤的自然史。

Natural history of multiple myeloma with de novo del(17p).

机构信息

Division of Hematology, Mayo Clinic, Rochester, MN, USA.

4th Department of Internal Medicine - Hematology, University Hospital Hradec Kralove and Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic, Hradec Kralove, Czech Republic.

出版信息

Blood Cancer J. 2019 Mar 7;9(3):32. doi: 10.1038/s41408-019-0191-y.

DOI:10.1038/s41408-019-0191-y
PMID:30846679
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6405846/
Abstract

We compared the outcomes of 310 patients with newly diagnosed multiple myeloma with del(17p) detected by FISH to patients with high-risk translocations (HRT) (n = 79) and standard-risk (SR) cytogenetics (n = 541). The median progression-free survival (PFS) following initial therapy for the three groups was 21.1, 22, and 30.1 months, respectively (P = 0.437- del(17p) vs. HRT); the median overall survival (OS) was 47.3, 79.1, and 109.8 months, respectively, (P = 0.007- del(17p) vs. HRT). PFS and OS for patients with relative loss of 17p (n = 21) were comparable to other patients with del(17p). The PFS was similar between the del(17p) and HRT groups when stratified for age, ISS stage or treatment. The OS of del(17p) and HRT groups were similar in presence of advanced age, ISS III stage or if patients did not receive a proteasome-inhibitor containing induction. ISS III stage, high LDH and HRT, but not the percentage of cells with del(17p) predicted shorter OS in patients with del(17p). The median OS for low (ISS I, normal LDH and no HRT), intermediate (neither low nor high-risk) and high-risk (ISS III and either elevated LDH or coexistent HRT) groups among del(17p) patients were 96.2, 45.4, and 22.8 months, respectively, allowing further risk stratification.

摘要

我们比较了 310 例通过 FISH 检测到存在 del(17p)的初诊多发性骨髓瘤患者与存在高危 t(11;14)（n=79）和标准风险（SR）细胞遗传学异常（n=541）患者的结局。三组患者初始治疗后的中位无进展生存期（PFS）分别为 21.1、22 和 30.1 个月（P=0.437- del(17p) 与 HRT 相比）；中位总生存期（OS）分别为 47.3、79.1 和 109.8 个月（P=0.007- del(17p) 与 HRT 相比）。存在相对 17p 缺失（n=21）患者的 PFS 与其他存在 del(17p)患者的 PFS 相似。当按年龄、ISS 分期或治疗分层时，del(17p)组与 HRT 组的 PFS 相似。在存在高龄、ISS III 期或未接受蛋白酶体抑制剂诱导治疗的情况下，del(17p)组和 HRT 组的 OS 相似。del(17p)和 HRT 组的 OS 在年龄较大、ISS III 期或存在时相似，如果患者没有接受蛋白酶体抑制剂诱导治疗。ISS III 期、高 LDH 和 HRT，但不是 del(17p)细胞的百分比，预测了存在 del(17p)患者的较短 OS。del(17p)患者中低危（ISS I、正常 LDH 和无 HRT）、中危（既非低危也非高危）和高危（ISS III 期和 LDH 升高或同时存在 HRT）组的中位 OS 分别为 96.2、45.4 和 22.8 个月，可进一步进行危险分层。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1c9/6405846/2c962abe9a07/41408_2019_191_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1c9/6405846/74b5226971bd/41408_2019_191_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1c9/6405846/25f8accb398e/41408_2019_191_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1c9/6405846/2c962abe9a07/41408_2019_191_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1c9/6405846/74b5226971bd/41408_2019_191_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1c9/6405846/25f8accb398e/41408_2019_191_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1c9/6405846/2c962abe9a07/41408_2019_191_Fig3_HTML.jpg

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