Liu Yuntong, Xu Jingyu, Yan Wenqiang, Ma Yueshen, Li Lingna, Cui Jian, Lv Rui, Du Chenxing, Qiu Lugui, An Gang
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 288 Nanjing Road, Tianjin, 300020, China.
Tianjin Institutes of Health Science, Tianjin, 301600, China.
Ann Hematol. 2024 Dec;103(12):5573-5581. doi: 10.1007/s00277-024-06026-x. Epub 2024 Oct 2.
We described 790 patients with newly diagnosed multiple myeloma, including 224 (28.4%) standard risk (SR) patients without t(11;14), 99 (12.5%) patients with t(11;14)alone, 58 (7.3%) with t(11;14) + HR, and 409 (51.8%) in the high-risk cytogenetic abnormality (HRCA) group including t(4;14), t(14;16), t(14;20), C1A1 and/or del(17p) but without t(11;14), to evaluate the impact of t(11;14) in NDMM patients on response rate, response kinetics and survival. Our study showed that NDMM patients in the t(11;14)alone group had similar PFS (49.3 vs. 50.7 months; P = 0.392) and OS (112.4 vs. NR months; P = 0.982) as those in the SR group. However, the t(11;14)alone group exhibited a significantly poorer depth of response compared to the SR group, particularly with a lower MRD negativity rate (60.0% vs. 76.0%, P = 0.009). In the t(11;14)alone group, MRD status did not significantly impact PFS or OS, which was in contrast to the other groups. Response kinetics analyses showed that the t(11;14)alone group had a slower response rate than the other subgroups (t(11;14)alone vs. SR vs. HRCA: median time to MRD negativity = 9.19 vs. 4.25 vs. 4.27 months; P < 0.001). Our study showed that t(11;14)alone was characterized by survival comparable to standard risk cytogenetics despite exhibiting the slowest timing of response onset and lowest plateau of remission, which suggested a relatively indolent clinical course.
我们描述了790例新诊断的多发性骨髓瘤患者，其中包括224例（28.4%）无t(11;14)的标准风险（SR）患者、99例（12.5%）单纯t(11;14)患者、58例（7.3%）t(11;14)+高危（HR）患者以及409例（51.8%）高危细胞遗传学异常（HRCA）组患者，该组包括t(4;14)、t(14;16)、t(14;20)、C1A1和/或del(17p)但无t(11;14)，以评估t(11;14)对新诊断多发性骨髓瘤（NDMM）患者缓解率、缓解动力学和生存的影响。我们的研究表明，单纯t(11;14)组的NDMM患者与SR组患者的无进展生存期（PFS）相似（49.3个月对50.7个月；P=0.392），总生存期（OS）也相似（112.4个月对未达到[NR]个月；P=0.982）。然而，与SR组相比，单纯t(11;14)组的缓解深度明显较差，尤其是微小残留病（MRD）阴性率较低（60.0%对76.0%，P=0.009）。在单纯t(11;14)组中，MRD状态对PFS或OS没有显著影响，这与其他组形成对比。缓解动力学分析表明，单纯t(11;14)组的缓解率比其他亚组慢（单纯t(11;14)组对SR组对HRCA组：达到MRD阴性的中位时间=9.19个月对4.25个月对4.27个月；P<0.001）。我们的研究表明，尽管单纯t(11;14)组的缓解起始时间最慢且缓解平台期最低，但其生存期与标准风险细胞遗传学相当，这表明其临床病程相对惰性。
