Distinct predictive impact of FISH abnormality in proteasome inhibitors and immunomodulatory agents response: redefining high-risk multiple myeloma in Asian patients

被引：15

作者：

Byun, Ja Min ^{[1
,2
]}

Shin, Dong-Yeop ^{[1
,3
]}

Hong, Junshik ^{[1
,3
]}

Kim, Inho ^{[1
,4
]}

Kim, Hyun Kyung ^{[5
]}

Lee, Dong Soon ^{[5
]}

Koh, Youngil ^{[1
,3
,4
]}

Yoon, Sung-Soo ^{[1
,3
,4
]}

机构：

[1] Seoul Natl Univ, Seoul Natl Univ Hosp, Coll Med, Dept Internal Med, Seoul, South Korea

[2] Seoul Natl Univ, Dept Internal Med, Seoul Metropolitan Govt, Boramae Med Ctr, Seoul, South Korea

[3] Seoul Natl Univ Hosp, Biomed Res Inst, Seoul, South Korea

[4] Seoul Natl Univ Hosp, Canc Res Inst, Seoul, South Korea

[5] Seoul Natl Univ, Dept Lab Med, Coll Med, Seoul, South Korea

来源：

CANCER MEDICINE | 2018年 / 7卷 / 03期

关键词：

Asian; immunomodulatory drugs; in situ hybridization; multiple myeloma; proteasome inhibitors; INTERNATIONAL STAGING SYSTEM; UPDATED MAYO STRATIFICATION; INITIAL TREATMENT; CLASSIFICATION; CYTOGENETICS; CONSENSUS; SURVIVAL; THERAPY; T(4/14); DISPARITIES;

D O I：

10.1002/cam4.1340

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

For risk-adaptive therapeutic approaches in multiple myeloma (MM) treatment, we analyzed treatment outcome according to in situ hybridization (FISH) profiles to investigate the prognostic and predictive values of structural variations in a large series of Asian population. A total of 565 newly diagnosed patients with multiple myeloma between January 2005 and June 2015 were evaluated. FISH results showed del(17p13) in 8.8% (29/331), del(13q14) in 35.5% (184/519), t(14;16) in 2.5% (8/326), t(4;14) in 27.9% (109/390), IgH rearrangement in 47.7% (248/520), and +1q21 in 40.8% (211/517). The presence of del(17p13), IgH rearrangement, and t(14;16) was associated with worse overall survival. Interestingly, however, the presence of t(4;14) conferred little prognostic impact. Treatment-specific analysis revealed the presence of del(17p13), t(14;16), IgH rearrangement, and trisomy 1q21 was predictive of unsatisfactory response to bortezomib. On the other hand, patients with del(13q14) and del(9p21) were less likely to benefit from lenalidomide. Autologous stem cell transplantation (autoSCT) was less effective in patients with del(17p13), t(14;16), and trisomy 1q21. Predictive values of del(17p13) and t(14;16) to bortezomib and autoSCT are seemingly universal, but predictive marker del(13q14) and del(9p21) for lenalidomide response appears ethnicity-specific. Thus, FISH profiles in MM treatment should be interpreted with regards to patient's ethnicity.

引用

页码：831 / 841

页数：11