Lim Kenneth Jc, Wellard Cameron, Talaulikar Dipti, Tan Joanne Lc, Loh Joanna, Puvanakumar Pratheepan, Kuzich James A, Ho Michelle, Murphy Matthew, Zeglinas Nicole, Low Michael Sy, Routledge David, Lim Andrew Bm, Gibbs Simon D, Quach Hang, Morgan Sue, Moore Elizabeth, Ninkovic Slavisa
Department of Haematology St Vincent's Hospital Melbourne Melbourne Australia.
Victorian Cancer Cytogenetics Service St. Vincent's Hospital Melbourne Melbourne Australia.
EJHaem. 2023 Jul 25;4(3):639-646. doi: 10.1002/jha2.742. eCollection 2023 Aug.
The prognostic impact of t(11;14) in multiple myeloma (MM) needs to be better understood to inform future treatment decisions. The Australian Lymphoma Leukaemia Group embarked on a retrospective, observational cohort study using real-world data to interrogate treatment patterns and outcomes in 74 MM patients with t(11;14) [t(11;14)-MM] diagnosed over 10 years. This was compared to 159 and 111 MM patients with high-risk IgH translocations (IgH HR-MM) and hyperdiploidy (Hyperdiploid-MM), respectively, from the Australian Myeloma and Related Diseases Registry. No appreciable differences in age, gender, ISS, LDH levels, 1q21 or del(17p) status, or treatment patterns were observed between groups. Median PFS-1 was not different between groups but both t(11;14)-MM and IgH HR-MM had an inferior PFS-2 vs. Hyperdiploid-MM: median PFS-2 8.2 months, 10.0 months, and 19.8 months ( = 0.002), respectively. The 3-year OS were 69%, 71%, and 82% ( = 0.026), respectively. In the t(11;14)-MM group, gain or amplification of 1q21 at diagnosis predicted for poorer OS (HR 3.46, = 0.002). Eleven patients had received venetoclax with 45% achieving better than a very good partial response. Results suggest that t(11;14) MM may confer an unfavorable risk profile and that the use of targeted therapies such as venetoclax earlier in the treatment algorithm should be explored.
为指导未来的治疗决策，需要更好地了解t(11;14)在多发性骨髓瘤（MM）中的预后影响。澳大利亚淋巴瘤白血病研究组开展了一项回顾性观察队列研究，利用真实世界数据，对10年间确诊的74例伴有t(11;14) [t(11;14)-MM]的MM患者的治疗模式和结局进行分析。将其与澳大利亚骨髓瘤及相关疾病登记处的159例高危免疫球蛋白重链（IgH）易位（IgH HR-MM）和111例超二倍体（Hyperdiploid-MM）MM患者进行比较。各组间在年龄、性别、国际分期系统（ISS）、乳酸脱氢酶（LDH）水平、1q21或17p缺失状态以及治疗模式方面均未观察到明显差异。各组间无进展生存期1（PFS-1）的中位数无差异，但t(11;14)-MM组和IgH HR-MM组的无进展生存期2（PFS-2）均低于Hyperdiploid-MM组：PFS-2的中位数分别为8.2个月、10.0个月和19.8个月（P=0.002）。3年总生存率分别为69%、71%和82%（P=0.026）。在t(11;14)-MM组中，诊断时1q21的获得或扩增预示总生存期较差（风险比[HR] 3.46，P=0.002）。11例患者接受了维奈克拉治疗，45%的患者获得了优于非常好的部分缓解的疗效。结果表明，t(11;14) MM可能具有不良风险特征，应探索在治疗方案中更早使用维奈克拉等靶向治疗。
