文章：

1号染色体长臂扩增与接受来那度胺、硼替佐米和地塞米松治疗的多发性骨髓瘤患者早期疾病进展相关

Gain of Chromosome 1q is associated with early progression in multiple myeloma patients treated with lenalidomide, bortezomib, and dexamethasone

原文发布日期：2019-11-25

DOI: 10.1038/s41408-019-0254-0

类型: Article

开放获取: 是

英文摘要：

Gain of chromosome 1q (+1q) is commonly identified in multiple myeloma and has been associated with inferior outcomes. However, the prognostic implication of +1q has not been evaluated in the setting of standard triplet regimens. We retrospectively analyzed 201 consecutive patients with newly diagnosed myeloma who received induction with lenalidomide, bortezomib, and dexamethasone (RVD) and were tested for +1q at diagnosis by fluorescent in-situ hybridization. Patients with +1q (n = 94), compared to those without +1q (n = 107), had shorter median progression-free survival (PFS) (41.9 months vs 65.1 months, p = 0.002, HR = 1.90) and overall survival (median not reached (NR) for either arm, p = 0.003, HR 2.69). In subgroup analyses, patients with co-occurring +1q and t(4;14), t(14;16) or del(17p) or with 4 or more copies of 1q had significantly worse PFS (25.1 months and 34.6 months, p < 0.001 and p = 0.0063, respectively), whereas patients with three copies and no other high-risk cytogenetic abnormalities had no significant difference in PFS. These data suggest that when treated with RVD induction, patients with +1q should be considered at very high risk for early progression in multiple myeloma when ≥4 copies are detected or in the context of other high-risk cytogenetic abnormalities.
 

摘要翻译： 

1q染色体获得（+1q）是多发性骨髓瘤中常见的遗传异常，并与不良预后相关。然而，在标准三联疗法背景下+1q的预后意义尚未得到评估。我们回顾性分析了201例连续入组的新诊断骨髓瘤患者，这些患者均接受来那度胺、硼替佐米和地塞米松（RVD）诱导治疗，并在诊断时通过荧光原位杂交检测+1q。与无+1q患者（n=107）相比，携带+1q的患者（n=94）中位无进展生存期（41.9个月 vs 65.1个月，p=0.002，HR=1.90）和总生存期（两组均未达中位值，p=0.003，HR=2.69）均显著缩短。亚组分析显示，同时存在+1q与t(4;14)、t(14;16)或del(17p)异常或1q拷贝数≥4的患者无进展生存期显著恶化（分别为25.1个月和34.6个月，p<0.001和p=0.0063），而仅有三拷贝且不伴其他高危细胞遗传学异常的患者无进展生存期无显著差异。这些数据表明，在接受RVD诱导治疗时，当检测到≥4个1q拷贝或存在其他高危细胞遗传学异常时，+1q患者应被视为具有早期进展的极高风险。

原文链接：

Gain of Chromosome 1q is associated with early progression in multiple myeloma patients treated with lenalidomide, bortezomib, and dexamethasone