Race-based differences in routine cytogenetic profiles of patients with multiple myeloma.
Race-based differences in routine cytogenetic profiles of patients with multiple myeloma.
复制标题
多发性骨髓瘤患者常规细胞遗传学特征中基于种族的差异。
DOI：
10.1111/bjh.13950
复制
发表时间：
2017
影响因子：
6.5
通讯作者：
Carson,KennethR
中科院分区：
文献类型：
--
作者：
Blue,BrandonJ;Luo,Suhong;Sanfilippo,KristenM;Ganti,Arun;Gumbel,Jason;O'Brian,Katiuscia;Carson,KennethR
多发性骨髓瘤（MM）是一种血液学恶性肿瘤，标准治疗无法治愈（Howlader等人，2014）。黑人患者的MM发生率是白色患者的2倍（Avet-Loiseau，et al 2010，Jagannath，et al 2007，Pineda-Roman，et al 2008，Sagaster，et al 2007）。尽管发生率增加，但黑人MM患者的总生存期更好（Howlader，et al 2014）。细胞遗传学是MM复发的重要因素（Corre and Avet-Loiseau 2011）。通过常规核型分析检测到的染色体13 q缺失或通过荧光原位杂交（FISH）检测到的t（4; 14）缺失与较差的治疗应答率相关，因此与较差的预后相关（Avet-Loiseau，et al 2010，Jagannath，et al 2007，Pineda-Roman，et al 2008，Sagaster，et al 2007）。较新的MM治疗，如硼替佐米和来那度胺，似乎对高风险和低风险细胞遗传学患者有效（Barlogie，et al 2008，Reece，et al 2009）。尽管在两种细胞遗传学特征方面均有效，但硼替佐米和来那度胺相关的生存改善可能不成比例地使白色患者获益，表明存在基于人种的细胞遗传学差异（Kumar，et al 2008）。我们对细胞遗传学的种族差异如何影响MM预后知之甚少，为了确定常见MM相关染色体异常的种族差异，我们对来自美国退伍军人健康管理局（VHA）的患者进行了回顾性队列研究，检查了常规细胞遗传学结果。使用VHA中央癌症登记研究确定了1998年10月1日至2009年12月31日期间诊断为MM的5，202例患者队列。使用国际肿瘤疾病分类第3版（ICD-O-3）编码9732/3、9731/3和9734/3（MM和浆细胞瘤）识别患者。在这些患者中，我们确定了一个由1,256名患者组成的子队列，这些患者的通用手术术语（CPT）代码为88271-8275、88291、88299、88365、83896、88237、88261-88264、88280、88283和88285，表明已进行常规细胞遗传学检测。对该子队列的电子记录的进一步检查提供了828例患者的核型分析结果。
Multiple myeloma (MM) is an haematological malignancy for which there is no cure with standard therapy (Howlader, et al 2014). Black patients have an incidence of MM that is twice that of white patients (Avet-Loiseau, et al 2010, Jagannath, et al 2007, Pineda-Roman, et al 2008, Sagaster, et al 2007). Despite the increased incidence, black patients with MM experience better overall survival (Howlader, et al 2014). Cytogenetics represent an important factor in MM prognostication (Corre and Avet-Loiseau 2011). Deletion of chromosome 13q, detected by routine karyotype analysis, or t (4; 14), detected by fluorescent in situ hybridization (FISH), have been associated with poorer treatment response rates and thus poorer prognosis (Avet-Loiseau, et al 2010, Jagannath, et al 2007, Pineda-Roman, et al 2008, Sagaster, et al 2007). Newer MM treatments, such as bortezomib and lenalidomide, appear to be effective in patients with high and low risk cytogenetics (Barlogie, et al 2008, Reece, et al 2009). Despite efficacy in both cytogenetic profiles, survival improvements associated with bortezomib and lenalidomide may disproportionately benefit white patients, suggesting race-based cytogenetic differences (Kumar, et al 2008). Little is known about how racial differences in cytogenetics may influence MM prognosis.To identify racial differences in common MM-associated chromosomal abnormalities, we examined routine cytogenetic results in a retrospective cohort study of patients from the United States Veterans Health administration (VHA). A cohort of 5,202 patients diagnosed with MM between 1 October 1998 and 31 December 2009 was identified using the VHA central cancer registry. Patients were identified with International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3) codes 9732/3, 9731/3 and 9734/3 (MM and plasmacytoma). Among these patients, we identified a sub-cohort of 1,256 patients who had common procedural terminology (CPT) codes 88271-8275, 88291, 88299, 88365, 83896, 88237, 88261-88264, 88280, 88283 and 88285, indicating that routine cytogenetic testing had been performed. Further examination of the electronic records of this sub-cohort provided results of karyotype analysis in 828 patients.