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NFKB 1 − 94ins/del ATTG polymorphism is a novel prognostic marker in first line‐treated multiple myeloma
Author(s) -
Varga Gergely,
Mikala Gábor,
Andrikovics Hajnalka,
Koszarska Magdalena,
Balassa Katalin,
Ádám Emma,
Kozma András,
Tordai Attila,
Masszi Tamás
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13197
Subject(s) - bortezomib , hazard ratio , medicine , multiple myeloma , allele , genotype , oncology , gastroenterology , confidence interval , biology , gene , genetics
Summary Nuclear factor kappa B ( NFKB ) plays an important role in multiple myeloma ( MM ), and bortezomib affects this pathway. We retrospectively analysed the effect of the NFKB 1 − 94ins/del ATTG polymorphism on the survival of 295 MM patients treated at a single centre. The median progression‐free survival ( PFS ) was 790 (659–921) d in patients with NFKB 1 homozygous insertion genotype (I/I, n = 99) and 624 (515–733) d in deletion‐carriers (I/D&D/D, n = 196, P = 0·013). In multivariate analysis, I/I carriers showed a favourable PFS compared to I/D&D/D with a hazard ratio of 0·622 (0·457–0·847), P = 0·003, in addition to international staging system ( ISS ) score, fluorescence in situ hybridization ( FISH ) risk score, age and bortezomib treatment. I/I patients benefited more from bortezomib treatment [ PFS 902 (703–1101) and 580 (343–817), P = 0·008] than I/D&D/D patients [ PFS 659 (487–831) and 488 (323–653), P = 0·531]; in addition the beneficial effect of low ISS score was not observed in the I/D&D/D group [ PFS 639 (454–824) and 650 (458–842), P = 0·226], while it was clear in I/I patients [ PFS 1140 (803–1477) and 580 (408–752), P < 0·001]. We conclude that homozygous carriers of the insertion allele of the NFKB 1 − 94ins/del ATTG polymorphism have a better prognosis and probably benefit more from bortezomib treatment than MM patients carrying the deletion allele.