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在现代治疗时代,伴有 1q 获得/扩增的多发性骨髓瘤患者的结局。

Outcomes of patients with multiple myeloma harboring chromosome 1q gain/amplification in the era of modern therapy.

机构信息

Division of Hematology-Oncology, Tufts Medical Center, Boston, MA, 02111, USA.

Department of Medicine, Tufts Medical Center, Boston, MA, 02111, USA.

出版信息

Ann Hematol. 2022 Feb;101(2):369-378. doi: 10.1007/s00277-021-04704-8. Epub 2021 Nov 8.

Abstract

Chromosome 1q gain/amplification (1q +) has been reported to be associated with inferior outcomes in multiple myeloma (MM) patients. Big therapeutic advances have shifted the treatment landscape by introducing monoclonal antibodies. There is a relative lack of data on outcomes in patients harboring this alteration in the era of monoclonal antibodies. Baseline characteristics and therapy-related data from newly diagnosed MM patients harboring 1q + detected by fluorescence in situ hybridization (FISH) were collected in a single institution. Among 34 identified subjects, the presence of elevated LDH was found to be associated with shorter overall survival (OS), and increased bone marrow plasma cell percentage (≥ 60%) was associated with worse progression-free survival (PFS). 1q + copy number more than three was associated with both shorter OS and PFS. Additionally, the administration of lenalidomide was associated with superior OS. The use of autologous stem cell transplantation, bortezomib, or daratumumab, was found to have no prognostic benefits in our sample. Lenalidomide may be an optimal therapeutic choice for this population, and future larger studies are warranted to confirm this benefit and further investigate the role of monoclonal antibodies in this subpopulation.

摘要

1q 染色体增益/扩增(1q+)已被报道与多发性骨髓瘤(MM)患者的不良预后相关。单克隆抗体的引入带来了重大的治疗进展,改变了治疗格局。在单克隆抗体时代,关于携带这种改变的患者结局的数据相对较少。在一家机构中收集了通过荧光原位杂交(FISH)检测到 1q+的新诊断 MM 患者的基线特征和治疗相关数据。在 34 名确定的受试者中,发现升高的 LDH 与总生存期(OS)缩短有关,骨髓浆细胞百分比(≥60%)增加与无进展生存期(PFS)更差相关。1q+拷贝数超过 3 与 OS 和 PFS 均缩短相关。此外,来那度胺的应用与更好的 OS 相关。在我们的样本中,自体干细胞移植、硼替佐米或达雷妥尤单抗的使用没有预后获益。来那度胺可能是该人群的最佳治疗选择,需要进一步的大型研究来证实这一益处,并进一步研究单克隆抗体在该亚群中的作用。

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