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Proteasome inhibitors and IM iDs can overcome some high‐risk cytogenetics in multiple myeloma but not gain 1q21
Author(s) -
Nahi Hareth,
Våtsveen Thea Kristin,
Lund Johan,
Heeg Bart M.S.,
Preiss Birgitte,
Alici Evren,
Møller Michael Boe,
Wader Karin Fahl,
Møller Hanne E.H.,
Grøseth Lill Anny,
Østergaard Brian,
Dai Hong Yan,
Holmberg Erik,
Gahrton Gösta,
Waage Anders,
Abildgaard Niels
Publication year - 2016
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12546
Subject(s) - medicine , cytogenetics , cohort , gastroenterology , population , weight gain , multiple myeloma , biology , chromosome , body weight , gene , genetics , environmental health
Chromosomal aberrations have significant prognostic importance in multiple myeloma ( MM ). However, proteasome inhibitors ( PI ) and IM iDs may partly overcome the poor prognostic impact of some of them. In this study, we investigated a population‐based consecutive cohort newly diagnosed patients with MM admitted during a defined time period to hospitals in Denmark, Norway, and Sweden. The impact of treatment modality on the prognostic importance of specific chromosomal aberration was investigated, with special reference to gain 1q21. The median follow‐up of patients still alive at analysis was 40 months for the high‐dose ( HDT )‐treated ones and 29 months for the whole population. Three hundred forty‐seven patients with a known 1q21 status were included in this study. The 347 patients were divided into three groups, that is, 119 patients with the 1q21 gain, 105 patients with other aberrations ( OA ), that is, del(13q), del(17p), t(4,14), and/or (14;16), and 123 patients with no aberrations ( NA ). The groups were compared in terms of overall survival ( OS ), time to progression ( TTP ), and response. The 3‐yr OS for patients with gain 1q21 was 60% compared to patients with OA 74% and NO 82% (gain 1q21 vs. NO P < 0.001; gain 1q21 vs. OA P = 0.095). If treated with PI or IM iDs, the 3‐yr OS was 58% for patients with gain 1q21 compared to patients with OA 78% and NO 78%, respectively ( P = 0.041, P = 0.140). In HDT patients, the 3‐yr OS was 69% for patients with gain 1q21 compared to patients with OA 84% and NO 88%, respectively ( P < 0.008, P = 0.600). Thus, neither HDT nor using PI or IM iDs could overcome the poor prognostic impact of gain 1q21, while these drugs and HDT seemed to improve OS in patients with OA , approaching the survival in NO . Further, gain 1q21 appears to be one of the most important poor prognostic chromosomal aberrations in multiple myeloma with current treatments. Trials using new drugs or allogeneic transplantation are warranted.