532例多发性骨髓瘤患者细胞遗传学异常及对预后的影响

OBJECTIVE: To explore the effect of 6 common cytogenetic abnormalities on the prognosis of multiple myeloma (MM). METHODS: Myeloma cells from a cohort of 532 newly-diagnosed MM patients enrolled were enriched by CD138 immunomagnetic beads, then detected 13q−, 17p−, 1q+, t(4;14), t(11;14) and t(14;16) and other common genetic abnormalities in MM by using interphase fluorescence in situ hybridization (FISH) technique to compare the influence of different genetic abnormalities on their prognoses. RESULTS: The rate of cytogenetic abnormalities was 78.20% (416/532) in 532 patients, of which 13q− accounted for 42.29% (225/532), 17p− 16.35% (87/532), 1q+ 53.38% (284/532), t(4;14) 25.94% (138/532), t(11;14) 21.62% (115/532), t(14;16) 2.07% (11/532). Six kinds of cytogenetic abnormalities were analyzed, 13q− and 17p−, 1q+, t (4; 14), t(14;16) were all correlated (P <0.05). The univariate analysis indicated that 13q−, 1q+, t(4;14) and t(14;16) had a significant effect on progression-free survival (PFS), 13q−, 17p−, t(4;14) and t(14;16) had a marked influence on overall survival (OS). The multivariate analysis showed that 1q+, t(4;14) and t(14;16) were independent adverse factors of PFS, 17p−, t(4;14) and t(14;16) were independent unfavorable factors of OS. According to the independent prognosis factors number-based groups, the median PFS with 0, 1, 2, 3 independent prognosis factors of patients were 30.9, 28.4, 18.7 and 17.6 months (P =0.035) respectively, and the median OS were 54.4, 46.1, 38.0 and 21.2 months (P =0.004) respectively. CONCLUSION: 1q+, 17p−, t(4;14) and t(14;16) were independent prognostic factors affecting the survival of MM patients. 13q− is often accompanied by 17p−, 1q + and (or) t(4;14), simply 13q− was not an independent prognostic factor; the more number of independent prognostic factors, the worse the prognosis of patients.