Zheng Xiaona, Lin Siyu, Lu Kejie, Hou Jian, Liu Tingting
Department of Hematology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 610041 P.R. China.
Oncol Lett. 2024 Oct 21;29(1):18. doi: 10.3892/ol.2024.14764. eCollection 2025 Jan.
The gain of chromosomal region 1q21 is a significant risk factor in multiple myeloma (MM) and is associated with poor prognosis. The introduction of bortezomib has notably improved outcomes for patients with MM. However, recent studies have reported conflicting results regarding the efficacy of bortezomib in mitigating the adverse effects of 1q21 aberration in these patients. To address this, in the present study, a meta-analysis was conducted based on 6 studies encompassing 1,575 patients with MM. The prognosis of patients with 1q21+ who underwent treatment with a bortezomib-based regimen was evaluated in terms of complete response (CR), overall survival (OS) and progression-free survival (PFS) rates. The results demonstrated that patients with 1q21 aberration were more likely to achieve CR than those without 1q21+ under bortezomib-based treatment [odds ratio, 0.64; 95% confidence interval (CI), 0.49-0.83; P=0.0008]. However, 1q21+ remained a high-risk factor in patients with MM even after bortezomib treatment [PFS: hazard ratio (HR), 1.72; 95% CI, 1.53-1.93; P<0.00001; and OS: HR, 1.95; 95% CI, 1.58-2.42; P<0.00001]. In conclusion, although bortezomib improved the likelihood of achieving CR in patients with 1q21+, this genetic aberration continues to be considered a high-risk factor in patients with MM treated with a bortezomib-based regimen.
染色体区域1q21的扩增是多发性骨髓瘤（MM）的一个重要风险因素，与预后不良相关。硼替佐米的引入显著改善了MM患者的治疗效果。然而，最近的研究报告了关于硼替佐米减轻这些患者1q21畸变不良影响疗效的相互矛盾的结果。为解决这一问题，在本研究中，基于6项涵盖1575例MM患者的研究进行了荟萃分析。根据完全缓解（CR）、总生存期（OS）和无进展生存期（PFS）率，评估了接受基于硼替佐米方案治疗的1q21+患者的预后。结果表明，在基于硼替佐米的治疗下，有1q21畸变的患者比没有1q21+的患者更有可能实现CR[优势比，0.64；95%置信区间（CI），0.49 - 0.83；P = 0.0008]。然而，即使在硼替佐米治疗后，1q21+在MM患者中仍然是一个高风险因素[PFS：风险比（HR），1.72；95% CI，1.53 - 1.93；P < 0.00001；OS：HR，1.95；95% CI，1.58 - 2.42；P < 0.00001]。总之，尽管硼替佐米提高了1q21+患者实现CR的可能性，但这种基因畸变在接受基于硼替佐米方案治疗的MM患者中仍然被认为是一个高风险因素。
