文章：

伴有1q获得/扩增的多发性骨髓瘤患者接受自体造血干细胞移植的结局：MD安德森癌症中心经验

Outcomes of patients with multiple myeloma and 1q gain/amplification receiving autologous hematopoietic stem cell transplant: the MD Anderson cancer center experience

原文发布日期：2024-01-10

DOI: 10.1038/s41408-023-00973-w

类型: Article

开放获取: 是

英文摘要：

The prognostic impact of additional copies of chromosome 1q (1q + ) on outcomes of newly-diagnosed multiple myeloma (NDMM) patients undergoing autologous transplantation (autoSCT) is unclear. We conducted a retrospective single-center analysis of NDMM patients with 1q21 gain/amplification (3 or ≥4 copies of 1q, respectively) that received autoSCT between 2008–2018. 213 patients were included (79% 1q gain; 21% 1q amplification). The most commonly used induction regimen was bortezomib, lenalidomide, and dexamethasone (41%). At day100 post-autoSCT and at best post-transplant response, 78% and 87% of patients achieved ≥VGPR, and 38% and 50% achieved MRD-negative ≥VGPR, respectively. Median PFS and OS for the entire cohort were 35.5 months and 81.4 months, respectively. On multivariable assessment for PFS, MRD negative ≥VGPR before autoSCT (HR 0.52, p = 0.013) was associated with superior PFS, whereas 1q amplification was associated with inferior PFS (2.03, p = 0.003). On multivariate analysis for OS, achieving MRD negative ≥VGPR at best post-transplant response was associated with superior survival (0.29, p < 0.001), whereas R-ISS III and concomitant del17p or t(4:14) were associated with inferior survival (6.95, p = 0.030, 2.33, p = 0.023 and 3.00, p = 0.047, respectively). In conclusion, patients with 1q+ NDMM, especially 1q amplification, have inferior survival outcomes compared to standard-risk disease after upfront autoSCT, though outcomes are better than other high-risk cytogenetic abnormalities.
 

摘要翻译： 

染色体1q额外拷贝（1q+）对新诊断多发性骨髓瘤（NDMM）患者接受自体干细胞移植（autoSCT）预后的影响尚不明确。我们对2008年至2018年间接受自体移植、伴有1q21获得/扩增（分别对应1q拷贝数为3或≥4）的NDMM患者进行了一项单中心回顾性分析。共纳入213例患者（79%为1q获得，21%为1q扩增）。最常用的诱导方案是硼替佐米、来那度胺联合地塞米松（41%）。在移植后第100天及移植后最佳反应时，分别有78%和87%的患者达到≥非常好的部分缓解（VGPR），38%和50%达到微小残留病阴性且≥VGPR。整个队列的中位无进展生存期（PFS）和总生存期（OS）分别为35.5个月和81.4个月。多变量PFS分析显示，移植前达到MRD阴性≥VGPR与更优的PFS相关（HR 0.52，p=0.013），而1q扩增与较差的PFS相关（HR 2.03，p=0.003）。多变量OS分析表明，移植后最佳反应时达到MRD阴性≥VGPR与更好的生存相关（HR 0.29，p<0.001），而R-ISS III分期、同时存在del17p或t(4;14)与较差的生存相关（HR分别为6.95，p=0.030；2.33，p=0.023；3.00，p=0.047）。总之，尽管1q+ NDMM患者（尤其是1q扩增）在接受一线自体移植后的生存结局优于其他高危细胞遗传学异常，但相较于标准风险疾病仍较差。

原文链接：

Outcomes of patients with multiple myeloma and 1q gain/amplification receiving autologous hematopoietic stem cell transplant: the MD Anderson cancer center experience