Role of additional chromosomal changes in the prognostic value of t(4;14) and del(17p) in multiple myeloma: the IFM experience
A partir de données portant sur 242 patients atteints d'un myélome multiple présentant la translocation t(4;14) et/ou la délétion del(17p), cette étude rétrospective française évalue l'association entre la présence d'anomalies chromosomiques supplémentaires et la survie des patients
In multiple myeloma, cytogenetic changes display important value for patients' outcome. In this setting, the most important changes are the del(17p), and the t(4;14), conferring a poor outcome. However, a certain heterogeneity is observed in 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 the t(4;14) (157 patients), or the del(17p) (110 patients), 25 patients presenting both abnormalities, using SNP-array. In patients with t(4;14), del(1p32) (p<0.001), del22q (p<0.05) and more than 30 chromosomal structural changes (p=0.01) negatively impacted PFS. For OS, del(13q14) (p=0.01), del(1p32) (p<0.001), and the number of chromosomal structural changes (p<0.05 and p=0.01 for [10;30[and more than 30 structural changes, respectively) worsened the prognosis of patients. For patients with del(17p), del6q (p=0.01) worsened the prognosis of patients, whereas trisomy 15 (p=0.01) and monosomy 14 (p=0.03) were found to have a protective effect on PFS. For OS, del(1p32) (p=0.01) worsened the prognosis of patients, whereas more than 8 numerical changes (p=0.004) 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 one main factor negatively impacting survival: del(1p32).
Blood , résumé, 2014