Shen N, Zhang J, Xia Y, Shen X X, Wang J, Jin Y Y, Zhang R, Li J Y, Chen L J
Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China.
Zhonghua Xue Ye Xue Za Zhi. 2023 Dec 14;44(12):989-994. doi: 10.3760/cma.j.issn.0253-2727.2023.12.004.
This study aimed to investigate the influence of FGFR3 gene mutations on the clinical characteristics and prognosis of patients with newly diagnosed multiple myeloma (NDMM) . A total of 198 patients with NDMM admitted to the Department of Hematology in Jiangsu Province Hospital between January 2016 and February 2023 were retrospectively analyzed. Next-generation sequencing and cytoplasmic light chain immunofluorescence with fluorescence in situ hybridization were performed for all patients. The prognostic significance of FGFR3 mutation and clinical features were analyzed using the Log-rank test and Cox proportional hazards model. Among 198 patients, 28 carried the FGFR3 gene mutation. These patients had significantly lower serum albumin levels, higher β(2)-microglobulin levels, advanced Revised International Staging System stages, more frequent occurrence of t (4;14) , and shorter median progression-free survival (PFS) time (28 months 33 months, =0.024) and overall survival (OS) time (54 months undefined, =0.028) than patients without FGFR3 mutation. Additionally, patients carrying either FGFR3 mutation or t (4;14) had lower PFS (30 months 38 months, =0.012) and OS (54 months undefined, =0.017) than those without. The Cox proportional hazards model identified FGFR3 mutation as an independent risk factor for PFS and OS. FGFR3 gene mutation was an unfavorable independent prognostic predictor for NDMM.
本研究旨在探讨成纤维细胞生长因子受体3(FGFR3)基因突变对新诊断的多发性骨髓瘤(NDMM)患者临床特征及预后的影响。回顾性分析了2016年1月至2023年2月期间江苏省人民医院血液科收治的198例NDMM患者。对所有患者进行了二代测序以及采用荧光原位杂交技术的胞质轻链免疫荧光检测。使用对数秩检验和Cox比例风险模型分析FGFR3基因突变的预后意义及临床特征。198例患者中,28例携带FGFR3基因突变。与未发生FGFR3基因突变的患者相比,这些患者的血清白蛋白水平显著降低,β2微球蛋白水平升高,国际分期系统修订版分期更晚,t(4;14)发生率更高,无进展生存期(PFS)的中位时间更短(28个月对33个月,P=0.024),总生存期(OS)时间更短(54个月对未定义,P=0.028)。此外,携带FGFR3基因突变或t(4;14)的患者的PFS(30个月对38个月,P=0.012)和OS(54个月对未定义,P=0.017)均低于未携带的患者。Cox比例风险模型确定FGFR3基因突变是PFS和OS的独立危险因素。FGFR3基因突变是NDMM不良的独立预后预测指标。