Wang Bei, Derman Benjamin A, Sukhanova Madina, Appelbaum Daniel, Cursio John, Zhang Wei, Jakubowiak Andrzej, Chiu Brian C-H
Department of Public Health Sciences, The University of Chicago, Chicago, IL.
Section of Hematology/Oncology, Department of Medicine, The University of Chicago, Chicago, IL.
Blood Neoplasia. 2024 Dec 26;2(1):100065. doi: 10.1016/j.bneo.2024.100065. eCollection 2025 Feb.
Cytogenetic abnormalities influence the prognosis of multiple myeloma (MM). How these abnormalities associate with overall survival (OS) in European Americans (EAs) and African Americans (AAs) remains unclear. We collected data on fluorescence in situ hybridization targeting 17 cytogenetic abnormalities from 181 patients newly diagnosed with MM between 2010 and 2019. Vital status was ascertained using the National Death Index. Baseline clinical data were retrieved from electronic medical records. Established high-risk cytogenetic abnormalities (HRCAs) include t(4;14), t(14;16), t(14;20), del 17p, and gain/amplification of 1q. In each population, we evaluated the associations between cytogenetic abnormalities and OS. Among 55 AAs and 126 EAs, 65 deaths occurred (median follow-up: 5.8 years). The distribution of the abnormalities was similar between EAs and AAs. High-risk MM, characterized by HRCAs, was associated with worse OS in EAs (hazard ratio [HR], 2.6; 95% confidence interval [CI], 1.3-5.5), but not AAs. Del 13q was associated with worse OS in both populations. Gain/amplification of 1q was associated with poorer OS in EAs (HR, 3.44; 95% CI, 1.3-9.3) but not AAs, whereas t(4;14) was associated with poorer OS in AAs (HR, 14.51; 95% CI, 2.3-92.3) but not EAs. These associations remained after controlling for prognostic factors or other HRCAs, highlighting the potential of population heterogeneity in the prognostic significance of cytogenetic abnormalities.
细胞遗传学异常影响多发性骨髓瘤（MM）的预后。目前尚不清楚这些异常在欧美裔美国人（EAs）和非裔美国人（AAs）中如何与总生存期（OS）相关。我们收集了2010年至2019年间181例新诊断MM患者中针对17种细胞遗传学异常的荧光原位杂交数据。通过国家死亡指数确定生存状态。从电子病历中检索基线临床数据。已确定的高危细胞遗传学异常（HRCAs）包括t(4;14)、t(14;16)、t(14;20)、17p缺失以及1q的获得/扩增。在每一组人群中，我们评估了细胞遗传学异常与总生存期之间的关联。在55名非裔美国人和126名欧美裔美国人中，发生了65例死亡（中位随访时间：5.8年）。欧美裔美国人和非裔美国人中异常的分布相似。以高危细胞遗传学异常为特征的高危MM在欧美裔美国人中与较差的总生存期相关（风险比[HR]，2.6；95%置信区间[CI]，1.3 - 5.5），但在非裔美国人中并非如此。13q缺失在两组人群中均与较差的总生存期相关。1q的获得/扩增在欧美裔美国人中与较差的总生存期相关（HR，3.44；95% CI，1.3 - 9.3），但在非裔美国人中并非如此，而t(4;14)在非裔美国人中与较差的总生存期相关（HR，14.51；95% CI，2.3 - 92.3），但在欧美裔美国人中并非如此。在控制预后因素或其他高危细胞遗传学异常后，这些关联仍然存在，突出了细胞遗传学异常预后意义中人群异质性的可能性。
