Treatment of multiple myeloma with high-risk cytogenetics: a consensus of the International Myeloma Working Group

被引：706

作者：

Sonneveld, Pieter ^{[1
]}

Avet-Loiseau, Herve ^{[2
]}

Lonial, Sagar ^{[3
]}

Usmani, Saad ^{[4
]}

Siegel, David ^{[5
]}

Anderson, Kenneth C. ^{[6
]}

Chng, Wee-Joo ^{[7
]}

Moreau, Philippe ^{[8
]}

Attal, Michel ^{[9
]}

Kyle, Robert A. ^{[10
]}

Caers, Jo ^{[11
]}

Hillengass, Jens ^{[12
]}

San Miguel, Jesus ^{[13
]}

van de Donk, Niels W. C. J. ^{[14
]}

Einsele, Hermann ^{[15
]}

Blade, Joan ^{[16
]}

Durie, Brian G. M. ^{[17
]}

Goldschmidt, Hartmut ^{[18
,19
]}

Mateos, Maria-Victoria ^{[20
]}

Palumbo, Antonio ^{[21
]}

Orlowski, Robert ^{[22
]}

机构：

[1] Erasmus MC Canc Inst, Dept Hematol, Rotterdam, Netherlands

[2] Univ Canc Ctr Toulouse, Lab Genom Myeloma, Toulouse, France

[3] Emory Univ, Sch Med, Winship Canc Inst, Atlanta, GA USA

[4] Carolinas Healthcare Syst, Levine Canc Inst, Charlotte, NC USA

[5] Hackensack Univ, Med Ctr, John Theurer Canc Ctr, Hackensack, NJ USA

[6] Dana Farber Canc Inst, Jerome Lipper Multiple Myeloma Ctr, Boston, MA 02115 USA

[7] Natl Univ Canc Inst, Div Hematol, Singapore, Singapore

[8] Univ Hosp, Dept Hematol, Nantes, France

[9] Purpan Univ Hosp, Dept Hematol, Toulouse, France

[10] Mayo Clin, Dept Lab Med & Pathol, Minneapolis, MN USA

[11] Univ Liege, Ctr Hosp, Dept Hematol, Liege, Belgium

[12] Heidelberg Univ, Sect Multiple Myeloma, Med Clin 5, Heidelberg, Germany

[13] Univ Navarra Clin, Ctr Invest Med Aplicada, Pamplona, Spain

[14] Free Univ Amsterdam, Med Ctr Amsterdam, Dept Hematol, Amsterdam, Netherlands

[15] Univ Klin Wurzburg, Med Clin 2, Wurzburg, Germany

[16] Univ Hosp Clin, Inst Invest Biomed August Pi & Sunyer, Barcelona, Spain

[17] Int Myeloma Fdn, North Hollywood, CA USA

[18] Univ Heidelberg Hosp, Heidelberg, Germany

[19] Natl Ctr Tumor Dis Heidelberg, Heidelberg, Germany

[20] Univ Hosp Salamanca, Dept Hematol, Salamanca, Spain

[21] Univ Turin, Myeloma Unit, Turin, Italy

[22] Univ Texas Houston, MD Anderson Canc Ctr, Dept Lymphoma Myeloma, Div Canc Med, 1515 Holcombe Blvd, Houston, TX 77030 USA

来源：

BLOOD | 2016年 / 127卷 / 24期

关键词：

STEM-CELL TRANSPLANTATION; ADVERSE PROGNOSTIC-FACTOR; LOW-DOSE DEXAMETHASONE; TOTAL THERAPY 3; GENE-EXPRESSION; INTERGROUPE FRANCOPHONE; PLUS DEXAMETHASONE; AUTOLOGOUS TRANSPLANTATION; LENALIDOMIDE MAINTENANCE; TANDEM TRANSPLANTATION;

D O I：

10.1182/blood-2016-01-631200

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The International Myeloma Working Group consensus updates the definition for high-risk (HR) multiple myeloma based on cytogenetics Several cytogenetic abnormalities such as t(4; 14), del(17/17p), t(14; 16), t(14; 20), nonhyperdiploidy, and gain(1q) were identified that confer poor prognosis. The prognosis of patients showing these abnormalities may vary with the choice of therapy. Treatment strategies have shown promise for HR cytogenetic diseases, such as proteasome inhibition in combination with lenalidomide/pomalidomide, double autologous stem cell transplant plus bortezomib, or combination of immunotherapy with lenalidomide or pomalidomide. Careful analysis of cytogenetic subgroups in trials comparing different treatments remains an important goal. Cross-trial comparisons may provide insight into the effect of new drugs in patients with cytogenetic abnormalities. However, to achieve this, consensus on definitions of analytical techniques, proportion of abnormal cells, and treatment regimens is needed. Based on data available today, bortezomib and carfilzomib treatment appear to improve complete response, progression-free survival, and overall survival in t(4; 14) and del(17/17p), whereas lenalidomide may be associated with improved progression-free survival in t(4; 14) and del(17/17p). Patients with multiple adverse cytogenetic abnormalities do not benefit from these agents. FISH data are implemented in the revised International Staging System for risk stratification.

引用

页码：2955 / 2962

页数：8

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