Contributions
Abstract: PB2219
Type: Publication Only
Background
For the past two decades, several chromosomal abnormalities (CA) of high-risk significance on the course of multiple myeloma (MM) were defined, aiming to establish different prognostic groups.
Aims
The aim of this study was to analyze the prognostic significance of the chromosome 1 molecular abnormalities in MM patients.
Methods
A total of 104 newly diagnosed MM transplant-ineligible (median age 68 years, range 65-80 years; 56 male/48 female), were analyzed in the study, with following distribution: IgG myeloma had 68 patients (65.4%), IgA 17 (16.3%), IgD 1 patients (1%), light chains 16 (15.4%), and non-secretory 2 (1.9%). According to the clinical stage (CS, Durie&Salmon), advanced III CS was found in 82 patients (78.8%), II in 14 (13.5%), and symptomatic I CS in 8 (7.7%) patients. The ISS score 1 had 30 (28.8%) patients, 40 (38.5%) ISS 2, and 34 patients (32.7%) had ISS 3. Renal impairment existed in 29 patients (27.9%). According to the Revised ISS core (R-ISS), the distribution was as follows: RSS I 43 patients (41.3%), II 37 (35.6%), and III 24 patients (23.1%). Applying interphase fluorescent in-situ hybridization (iFISH) with probe 1p32/1q21 (CDKN2C/CKS1B), chromosome 1 abnomalities were identified in 54 (59.3%) patients: del1p32 in 16 patients (29.6%); and +1q21 in 38 patients (70.4%). Thalidomide based combinations were applied in 86 patients (82.7%), while bortezomib based combinations were applied in 18 patients (17.3%) with high-risk features.
Results
The overall treatment response (CR/VGPR/PR, IMWG criteria) with chr1 abnormalities, was achieved in 32 patients (51.9%): in 10/32 patients (31.3%) with del1p32; and 22/32 patients with +1q21 (68.7%). The median follow up of analyzed group was 22 months (range 6-100 months). Patients with chromosome 1 abnormalities had shorter PFS, still without statistical significance (Breslow 2.499; p=0.114), and statistically significant shortness of OS (Breslow 5.344; p=0.016). However, statistical analysis did not confirm the prognostic impact of +1q21 (PFS: Breslow 2.123, p=0.145; OS: Breslow 1.833, p=0.176), or del1p32 (PFS: Breslow 0.366, p=0.545; OS: Breslow 0.505, p=0.477). In addition, Cox regression analysis indicated R-ISS3 as the most important prognostic parameter that influenced OS (95% CI, 1.760-7.1429; p=0.006).
Conclusion
Molecular abnormalities of the chromosome 1 are of the negative prognostic significance in the MM patients. Still, it seems that R-ISS score 3 is of major impact on the course of disease with subsequent implications on the treatment approach.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Myeloma, prognosis, Treatment
Abstract: PB2219
Type: Publication Only
Background
For the past two decades, several chromosomal abnormalities (CA) of high-risk significance on the course of multiple myeloma (MM) were defined, aiming to establish different prognostic groups.
Aims
The aim of this study was to analyze the prognostic significance of the chromosome 1 molecular abnormalities in MM patients.
Methods
A total of 104 newly diagnosed MM transplant-ineligible (median age 68 years, range 65-80 years; 56 male/48 female), were analyzed in the study, with following distribution: IgG myeloma had 68 patients (65.4%), IgA 17 (16.3%), IgD 1 patients (1%), light chains 16 (15.4%), and non-secretory 2 (1.9%). According to the clinical stage (CS, Durie&Salmon), advanced III CS was found in 82 patients (78.8%), II in 14 (13.5%), and symptomatic I CS in 8 (7.7%) patients. The ISS score 1 had 30 (28.8%) patients, 40 (38.5%) ISS 2, and 34 patients (32.7%) had ISS 3. Renal impairment existed in 29 patients (27.9%). According to the Revised ISS core (R-ISS), the distribution was as follows: RSS I 43 patients (41.3%), II 37 (35.6%), and III 24 patients (23.1%). Applying interphase fluorescent in-situ hybridization (iFISH) with probe 1p32/1q21 (CDKN2C/CKS1B), chromosome 1 abnomalities were identified in 54 (59.3%) patients: del1p32 in 16 patients (29.6%); and +1q21 in 38 patients (70.4%). Thalidomide based combinations were applied in 86 patients (82.7%), while bortezomib based combinations were applied in 18 patients (17.3%) with high-risk features.
Results
The overall treatment response (CR/VGPR/PR, IMWG criteria) with chr1 abnormalities, was achieved in 32 patients (51.9%): in 10/32 patients (31.3%) with del1p32; and 22/32 patients with +1q21 (68.7%). The median follow up of analyzed group was 22 months (range 6-100 months). Patients with chromosome 1 abnormalities had shorter PFS, still without statistical significance (Breslow 2.499; p=0.114), and statistically significant shortness of OS (Breslow 5.344; p=0.016). However, statistical analysis did not confirm the prognostic impact of +1q21 (PFS: Breslow 2.123, p=0.145; OS: Breslow 1.833, p=0.176), or del1p32 (PFS: Breslow 0.366, p=0.545; OS: Breslow 0.505, p=0.477). In addition, Cox regression analysis indicated R-ISS3 as the most important prognostic parameter that influenced OS (95% CI, 1.760-7.1429; p=0.006).
Conclusion
Molecular abnormalities of the chromosome 1 are of the negative prognostic significance in the MM patients. Still, it seems that R-ISS score 3 is of major impact on the course of disease with subsequent implications on the treatment approach.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Myeloma, prognosis, Treatment