Predictive value of 1q21 gain in multiple myeloma is strongly dependent on concurrent cytogenetic abnormalities and first-line treatment.

Autor:	Minguela A; Immunology Service, Clinic University Hospital Virgen de la Arrrixaca (HCUVA), Biomedical Research Institute of Murcia (IMIB) Murcia, Spain., Vasco-Mogorrón MA; Immunology Service, Clinic University Hospital Virgen de la Arrrixaca (HCUVA), Biomedical Research Institute of Murcia (IMIB) Murcia, Spain., Campillo JA; Immunology Service, Clinic University Hospital Virgen de la Arrrixaca (HCUVA), Biomedical Research Institute of Murcia (IMIB) Murcia, Spain., Cabañas V; Hematology Service, Clinic University Hospital Virgen de la Arrrixaca (HCUVA), Biomedical Research Institute of Murcia (IMIB) Murcia, Spain., Remigia MJ; Department of Hematology, University Hospital La Fe and School of Medicine and Dentistry, Catholic University of Valencia Valencia, Spain., Berenguer M; Hematology Service, General University Hospital Santa Lucía, Biomedical Research Institute of Murcia (IMIB) Murcia, Spain., García-Garay MC; Hematology Service, Clinic University Hospital Virgen de la Arrrixaca (HCUVA), Biomedical Research Institute of Murcia (IMIB) Murcia, Spain., Blanquer M; Hematology Service, Clinic University Hospital Virgen de la Arrrixaca (HCUVA), Biomedical Research Institute of Murcia (IMIB) Murcia, Spain., Cava C; Hematology Service, General University Hospital Rafael Méndez, Biomedical Research Institute of Murcia (IMIB) Murcia, Spain., Galian JA; Immunology Service, Clinic University Hospital Virgen de la Arrrixaca (HCUVA), Biomedical Research Institute of Murcia (IMIB) Murcia, Spain., Gimeno L; Immunology Service, Clinic University Hospital Virgen de la Arrrixaca (HCUVA), Biomedical Research Institute of Murcia (IMIB) Murcia, Spain.; Human Anatomy Department, Medicine Faculty, Murcia University, Biomedical Research Institute of Murcia (IMIB) Murcia, Spain., Soto-Ramírez MF; Immunology Service, Clinic University Hospital Virgen de la Arrrixaca (HCUVA), Biomedical Research Institute of Murcia (IMIB) Murcia, Spain., Martínez-Hernández MD; Immunology Service, Clinic University Hospital Virgen de la Arrrixaca (HCUVA), Biomedical Research Institute of Murcia (IMIB) Murcia, Spain., de la Rubia J; Department of Hematology, University Hospital La Fe and School of Medicine and Dentistry, Catholic University of Valencia Valencia, Spain., Teruel AI; Department of Hematology, University Hospital La Fe and School of Medicine and Dentistry, Catholic University of Valencia Valencia, Spain., Muro M; Immunology Service, Clinic University Hospital Virgen de la Arrrixaca (HCUVA), Biomedical Research Institute of Murcia (IMIB) Murcia, Spain., Periago A; Hematology Service, General University Hospital Rafael Méndez, Biomedical Research Institute of Murcia (IMIB) Murcia, Spain.
Jazyk:	angličtina
Zdroj:	American journal of cancer research [Am J Cancer Res] 2021 Sep 15; Vol. 11 (9), pp. 4438-4454. Date of Electronic Publication: 2021 Sep 15 (Print Publication: 2021).
Abstrakt:	Improved therapies in multiple myeloma (MM) have forced a constant risk stratification update, first Durie-Salmon, then international scoring systems (ISS), next revised-ISS (RISS) including high-risk cytogenetic abnormalities (HRCAs) such as del(17p) and t(4;14), and now R2-ISS including 1q21 gain has been proposed. Predictive value of 1q21 gain by itself or in concurrence with other cytogenetic abnormalities is evaluated in 737 real-world plasma cell neoplasm (PCN) patients under current therapies. Ten-year progression-free survival (10y-PFS) rates for patients with 2, 3 and >3 copies of 1q21 were 72.2%, 42.5% and 43.4% (P<1.1×10 -17 ). Cox regression analysis confirmed that 1q21 gain was an independent prognostic factor for PFS (HR=1.804, P<0.0001, Harrell C-statistic =0.7779±0.01495) but not for OS (P=0.131). Gain of 1q21 was strongly associated with hypodiploidy (38.8% vs. 7.0%, P=1.3×10 -22 ), hyperdiploidy (44.1% vs. 16.4%, P=1.6×10 -13 ), HRCAs (12.6% vs. 3.5%, 1.8×10 -5 ), IGH breaks (12.3% vs. 2.1%, P=2.1×10 -7 ) and del(13q) (8.0% vs. 4.0%, P=0.031). In our series, 1q21 gain by itself did not improve RISS predictive capacity in patients either eligible or ineligible for autologous stem cell transplantation (ASCT). However, compared with patients with other 1q21 gains: concurrence with hyperdiploidy improved the prognosis of ASCT-eligible patients from 62.5% to 96.0% 10-year overall-survival (10y-OS, P<0.002); concurrence with hypodiploidy improved the prognosis of ASCT-ineligible patients from 35.7% to 71.0% (P=0.013); and concurrence with del(13q) worsened the prognosis of ASCT-ineligible patients from 12.5% to 53.4% (P=0.035). Gain of 1q21 should be patient-wisely evaluated, irrespective of the RISS, considering its concurrence with other cytogenetic abnormalities and eligibility for ASCT. Competing Interests: None. (AJCR Copyright © 2021.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu