Role of additional chromosomal changes in the prognostic value of t(4;14) and del(17p) in multiple myeloma: the IFM experience

其他染色体变化对多发性骨髓瘤 t(4;14) 和 del(17p) 预后价值的影响:IFM 经验

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作者:Benjamin Hebraud, Florence Magrangeas, Alice Cleynen, Valerie Lauwers-Cances, Marie-Lorraine Chretien, Cyrille Hulin, Xavier Leleu, Edwige Yon, Gerald Marit, Lionel Karlin, Murielle Roussel, Anne-Marie Stoppa, Karim Belhadj, Laurent Voillat, Laurent Garderet, Margaret Macro, Denis Caillot, Mohamad M

Abstract

In multiple myeloma, cytogenetic changes are important predictors of patient outcome. In this setting, the most important changes are deletion 17p, del(17p), and translocation of chromosomes 4 and 14, t(4;14), conferring a poor outcome. However, a certain degree of heterogeneity is observed in the survival of these high-risk patients. We hypothesized that other chromosomal changes may impact the outcome. We retrospectively analyzed a large series of 242 patients displaying either t(4;14) (157 patients) or del(17p) (110 patients), 25 patients presenting both abnormalities, using single nucleotide polymorphism array. In patients with t(4;14), del(1p32), del22q, and >30 chromosomal structural changes negatively impacted progression-free survival (PFS). For overall survival (OS), del(13q14), del(1p32), and the number of chromosomal structural changes worsened the prognosis of patients. For patients with del(17p), del6q worsened the prognosis of patients, whereas trisomy 15 and monosomy 14 were found to have a protective effect on PFS. For OS, del(1p32) worsened the prognosis of patients, whereas having >8 numerical changes was found to have a protective effect on survival. This study, which is the largest series of high-risk patients analyzed with the most modern genomic technique, identified 1 main factor negatively impacting survival: del(1p32).

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