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Leuk Res. 2014 Feb;38(2):188-93. doi: 10.1016/j.leukres.2013.11.010. Epub 2013 Nov 19.

Cytogenetic and clinical risk factors for assessment of ultra high-risk multiple myeloma.

Author information

1
Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: zhuangjunling@hotmail.com.
2
Department of Endocrinology, Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: da_yi@sina.com.
3
Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: lh10205@sina.com.
4
Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: hanbing_li@sina.com.
5
Department of Epidermiology, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730 China. Electronic address: wanxiasnake@163.com.
6
Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: tienanzhu@gmail.com.
7
Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: zhenyucmpal@sina.com.
8
Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: mhduan@sina.com.
9
Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: xy901@tom.com.
10
Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: pumchzhaoyq@aliyun.com.
11
Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: shent@pumch.cn.
12
Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: emmyzhuang@sina.com.
13
Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: daobinzhou@yahoo.com.

Abstract

BACKGROUND:

Cytogenetic assessments can improve conventional clinical risk assessment for ultra-high risk (UHR) multiple myeloma (MM) patients.

OBJECTIVE:

Cytogenetic and clinical risk factors were examined in UHR MM patients.

METHODS:

Consecutive MM patients (n = 168) were retrospectively screened for untreated, symptomatic MM between July 2008 and March 2011, including UHR (n = 35) and control (n = 60) patients with ≤ 12 or >12 month survival, respectively. Treatment outcomes; clinical, radiological, histological factors; and fluorescence in situ hybridization (FISH)-indicated cytogenetic abnormalities (CAs) were compared.

RESULTS:

Included UHR patients exhibited lower median overall survival (OS) (5 vs. >24 months); overall response rates (ORRs) (31.4% vs. 83.3%); complete response (CR), near CR (nCR), or very good partial response (VGPR) (8.6% vs. 51.7%) (all P<0.001); and partial response (PR) (22.9% vs. 31.7%, P = 0.358). UHR patients exhibited more renal failure (54.3% vs. 28.3%), hypercalcemia (11.4% vs. 0), elevated lactate dehydrogenase (LDH) (25.7% vs. 5%), secondary plasma cell leukemia (14.3% vs. 0), International Staging System (ISS) stage III (77.1% vs. 45%), and 1q21+ and 17p- (42.9% vs. 18.3%; 17.1% vs. 3.3%) (all P<0.05). ≥ 3 CAs indicated poor survival (36.7% vs. 16.1%, P = 0.035). Multivariate analysis showed ISS stage and LDH correlated with UHR (P = 0.05 and P =0.01, respectively), and 1q21+ and 17p- were increased but non-significantly correlated with UHR (P = 0.15 and P = 0.2, respectively).

CONCLUSIONS:

Combined clinical and cytogenetic assessments optimally indicate UHR MM patients' prognosis, allowing earlier risk-adapted interventions.

KEYWORDS:

Cytogenetic; Lactate dehydrogenase; Multiple myeloma; Prognosis; Risk factors; Ultra high-risk

PMID:
24342807
DOI:
10.1016/j.leukres.2013.11.010
[Indexed for MEDLINE]
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