摘要
目的 分析伴高危细胞遗传学异常(HRCA)及不同遗传学异常组合的初治多发性骨髓瘤(MM)患者的临床特征及预后,探讨HRCA的预后价值.方法 回顾性分析2009年11月至2018年5月收治的182例初诊MM患者.HRCA包括FISH检出的1q+、del(17p)、t(4;14)、t(14;16),非HRCA包括FISH检出的del(13q)、t(11;14).比较仅携带单一HRCA与1种HRCA伴非HRCA及≥2种HRCA(即'双/三打击')组间临床特征的差异,应用Kaplan-Meier曲线分析其对生存的影响.结果 1种HRCA伴非HRCA组与≥2种HRCA组(即'双/三打击')中位无进展生存(PFS)时间分别为19.1和12.1个月(P=0.248),中位总生存(OS)时间为29.6和29.3个月(P=0.774),均分别低于仅携带单一HRCA组(中位PFS时间32.2个月,P=0.040,P=0.001;中位OS时间42.3个月,P=0.021,P=0.041).合并分析后显示:1种HRCA伴其他遗传学异常组(无论高危、非高危)生存时间较仅携带单一HRCA组明显缩短[中位PFS时间15.1对32.2个月(HR=2.126,95%CI 1.176~3.843,P=0.005);中位OS 29.3对42.3个月(HR=1.442,95%CI 0.705~2.950,P=0.011)].结论 基于FISH细胞遗传学检测'双/三打击'具有重要预后价值.
Objectives To evaluate the clinical characteristics and prognosis of high risk cytogenetic abnormalities(HRCA)and various combinations of cytogenetic abnormality in patients with newly-diagnosed multiple myeloma(NDMM).Methods This retrospective study collected 182 NDMM patients in the First Affiliated Hospital of Jilin University between Nov.2009 and May 2018.HRCA included 1q+,del(17p),t(4;14),and t(14;16)detected by FISH,and non-HRCA included del(13q),t(11;14)detected by FISH.The clinical characteristics among three groups,including cases who carrying a single HRCA,1 HRCA in combination with non-HRCA and cases carrying two or more HRCAs(double/triple-hit)were observed.Kaplan-Meier curve was used to analyze both progression-free survival(PFS)and overall survival(OS)for the three groups.Results The survivals of patients with 1 HRCA in combination with non-HRCA were similar to those with two or more HRCAs(double/triple-hit),the median PFS(mPFS)was 19.1 m vs 12.1 m(P=0.248)and median OS(mOS)was 29.6 m vs 29.3 m(P=0.774).Furthermore,the prognosis of these two groups were both inferior to patients with a single HRCA,respectively.(mPFS:32.2 m,P=0.040,P=0.001;mOS:42.3 m,P=0.021,P=0.041).Strikingly,both the mPFS and the mOS of patients with 1 HRCA in combination with non-HRCA(regardless of high risk or not)were significantly shorter than that of cases with a single HRCA(mPFS:15.1 m vs 32.2 m,HR=2.126,95%CI 1.176-3.843,P=0.005;mOS:29.3 m vs 42.3 m,HR=1.442,95%CI 0.705-2.950,P=0.011).Conclusion It is of prognostic significance value for detecting double/triple-hit based on FISH cytogenetics in NDMM.
作者
刘雪莲
白晶
樊红琼
杨艳萍
岳婷婷
张烨
杨珮钰
高素君
李薇
靳凤艳
Liu Xuelian;Bai Jing;Fan Hongqiong;Yang Yanping;Yue Tingting;Zhang Ye;Yang Peiyu;Gao Sujun;Li Wei;Jin Fengyan(Department of Hematology,Cancer Center,the First Affiliated Hospital of Jilin University,Changchun 130021,China)
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2019年第8期644-649,共6页
Chinese Journal of Hematology
基金
国家自然科学基金(81670190).
关键词
多发性骨髓瘤
细胞遗传学异常
高危
预后
Multiple myeloma
Cytogenetic abnormality
High risk
Prognosis
作者简介
通信作者:靳凤艳,Email:fengyanjin@jlu.edu.cn
