Impact of primary molecular cytogenetic abnormalities and risk of progression in smoldering multiple myeloma
Impact of primary molecular cytogenetic abnormalities and risk of progression in smoldering multiple myeloma
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DOI：
10.1038/leu.2013.86
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发表时间：
2013-08-01
期刊：
影响因子：
11.4
通讯作者：
Kumar, S. K.
中科院分区：
文献类型：
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作者：
Rajkumar, S. V.;Gupta, V.;Kumar, S. K.
我们研究了351例郁积型多发性骨髓瘤（SMM）患者，根据细胞质免疫球蛋白荧光原位杂交研究，可以确定潜在的主要分子细胞遗传学亚型。127例（36.2%）有免疫球蛋白重链（IgH）易位，14例（4%）同时有三体性和IgH易位，53例（15.1%）未检测到异常，3例（0.9%）有单体13/del（13 q）。在127例IgH易位患者中，57例为t（11;14），36例为t（4;14），11例为肌肉腱膜纤维肉瘤（MAF）易位，23例为其他或未知IgH易位伴侣。与t（11;14）患者相比，t（4;14）患者至症状性多发性骨髓瘤的进展时间（TTP）显著更短，中位数分别为28个月和55个月，P = 0.025。中位TTP为28个月，t（4;14）（高风险），34个月，仅三体（中危），55个月，t（11; 14）、MAF易位、其他/未知IgH易位、无其他异常的单体13/del（13 q），以及三体和IgH易位（标准风险），未检测到异常的患者未达到（低风险），P = 0.001。缺失17 p时TTP有缩短的趋势（中位TTP，24个月）。t（4;14）组诊断为SMM后的总生存期显著低于t（11;14）组，中位数分别为105个月和147个月，P = 0.036。
We studied 351 patients with smoldering multiple myeloma (SMM) in whom the underlying primary molecular cytogenetic subtype could be determined based on cytoplasmic immunoglobulin fluorescent in situ hybridization studies. Hundred and fifty-four patients (43.9%) had trisomies, 127 (36.2%) had immunoglobulin heavy chain (IgH) translocations, 14 (4%) both trisomies and IgH translocations, 53 (15.1%) no abnormalities detected and 3 (0.9%) had monosomy13/del(13q) in the absence of any other abnormality. Among 127 patients with IgH translocations, 57 were t(11;14), 36 t(4;14), 11 musculoaponeurotic fibrosarcoma (MAF) translocations, and 23 other or unknown IgH translocation partner. Time to progression (TTP) to symptomatic multiple myeloma was significantly shorter in patients with the t(4;14) compared with patients with t(11;14), median 28 versus 55 months, respectively, P = 0.025. The median TTP was 28 months with t(4;14) (high-risk), 34 months with trisomies alone (intermediate-risk), 55 months with t(11;14), MAF translocations, other/unknown IgH translocations, monosomy13/del(13q) without other abnormalities, and those with both trisomies and IgH translocations (standard-risk), and not reached in patients with no detectable abnormalities (low-risk), P = 0.001. There was a trend to shorter TTP with deletion 17p (median TTP, 24 months). Overall survival from diagnosis of SMM was significantly inferior with t(4;14) compared with t(11;14), median 105 versus 147 months, respectively, P = 0.036.