Hypodiploidy is a major prognostic factor in multiple myeloma
Hypodiploidy is a major prognostic factor in multiple myeloma
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DOI：
10.1182/blood.v98.7.2229
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发表时间：
2001-10-01
期刊：
影响因子：
20.3
通讯作者：
Fruchart, C
中科院分区：
文献类型：
--
作者：
Smadja, NV;Bastard, C;Fruchart, C
法国细胞遗传学血液学研究组对208例多发性骨髓瘤患者在任何治疗前进行的常规核型进行了审查。共有138例患者表现出复杂的染色体异常（CCA）。根据染色体数目模式，第一组75名患者具有超二倍体核型。第二组63名患者被称为亚二倍体组，具有假二倍体、亚二倍体或近四倍体核型。在159例可用于生存分析的治疗患者中，116例有异常核型。超二倍体和亚二倍体患者的总生存期（OS）比较显示出非常显著的差异（中位OS分别为33.8和12.6个月，P <0.001）。14 q32重排的存在（116例患者中的36例）使预后恶化（中位OS 17.6 vs 29.9个月，P <0.02）。染色体13 q异常（13 qA，63例患者）的存在并没有改变CCA患者的OS（中位OS 20.6 vs 27.8个月，P <0.59）。然而，考虑到包括正常核型在内的整个系列，13 qA（159例患者中的63例）对OS有显著影响（中位数20.6 vs 37.1个月，P <0.04）。同样，亚二倍体核型的存在（159例患者中的52例）具有很强的预后价值（OS 12.8 vs 44.5个月，P <0.00001）。多变量分析包括分期、β 2-微球蛋白、骨髓浆细胞增多症、治疗类型、13 qA、超二倍体和亚二倍体，结果显示亚二倍体核型是影响OS的第一独立因素（P <0.001），其次是治疗方法。这些结果证实，恶性浆细胞的染色体数目模式是一个非常强大的预后因素，在新诊断的多发性骨髓瘤患者。(C)2001年，美国血液学会。
Conventional karyotypes performed before any treatment in 208 patients with multiple myeloma were reviewed by the Groupe Francais de Cytogenetique Hematologique. A total of 138 patients displayed complex chromosomal abnormalities (CCAs). According to the chromosome number pattern, a first group of 75 patients had a hyperdiploid karyotype. A second group of 63 patients referred to as the hypodiploid group had either pseudodiploid, hypodiploid, or near-tetraploid karyotypes. Of 159 treated patients available for survival analysis, 116 had an abnormal karyotype. The comparison of overall survival (OS) between hyperdiploid and hypodiploid patients showed a highly significant difference (median OS 33.8 vs 12.6 months, respectively, P < .001). The presence of 14q32 rearrangements (36 of 116 patients) worsened the prognosis (median OS 17.6 vs 29.9 months, P < .02). The presence of chromosome 13q abnormalities (13qA, 63 patients) did not modify OS in CCA patients (median OS 20.6 vs 27.8 months, P < .59). However, taking into account the whole series including normal karyotypes, 13qA (63 of 159 patients) had a significant impact on OS (median 20.6 vs 37.1 months, P < .04). In the same way, the presence of a hypodiploid karyotype (52 of 159 patients) had a strong prognostic value (OS 12.8 vs 44.5 months, P < .000 01). A multivariate analysis including stage, beta (2)-microglobulin, bone marrow plasmocytosis, treatment type, 13qA, and hyperdiploidy and hypodiploidy showed that a hypodiploid karyotype was the first independent factor for OS (P < .001), followed by treatment approach. These results confirm that the chromosome number pattern of malignant plasma cells is a very powerful prognostic factor in newly diagnosed multiple myeloma patients. (C) 2001 by The American Society of Hematology.