The Role of 1q21 Gain on the Prognosis of Multiple Myeloma

Multiple myeloma(MM)is a clonal expansion of malignant plasma cells,and comprises approximately 10%of hematologic malignancies.Although various therapeutic agents and strategies,such as immunomodulatory agents,proteasome inhibitors,monoclonal antibodies and hematopoietic stem cell transplantation(HSCT)have been evaluated,MM remains largely incurable.It is therefore important to further explore the risk factors for disease progression,and to design trials aimed at improving the patient outcomes.Previous studies have considered the presence of a gain in 1q21 as a risk factor for a poorer overall survival.Gain of 1q21 is one of the most common chromosomal aberrations in MM,being detected by fluorescence in situ hybridization in 36%to 47%of newly-diagnosed patients,as well as 52%and 62%patients with relapsed MM.Although a series of reports identified 1q21 gain in MM as a significant and independent poor prognostic factor,other studies failed to demonstrate any prognostic value.Thus,the prognostic value of 1q21 gain in MM remains controversial.We reviewed the current knowledge about 1q21 gain and its value for the clinical management of MM.

Clinical characteristics and prognostic values of 1p32.3 deletion detected through fluorescence in situ hybridization in patients with newly diagnosed multiple myeloma: a single-center study in China

This study aimed to investigate the prevalence,clinical characteristics,and prognostic impact of 1p32.3 deletion in patients with newly diagnosed multiple myeloma (MM).A retrospective analysis was conducted on 411 patients with newly diagnosed MM;among which,270 received bortezomib-based therapies,and 141 received thalidomide-based therapies.Fluorescence in situ hybridization (FISH) was performed to detect six cytogenetic abnormalities,namely,del(1p32.3),gain(1q21),del(17p13),del(13q14),t(4;14),and t(11;14).Results showed that 8.3% of patients with MM were detected with del(1p32.3) and had significantly more bone marrow plasma cells (P =0.025),higher β2-microglobulin levels (P =0.036),and higher lactate dehydrogenase levels (P =0.042) than those without del(1p32.3).Univariate analysis showed that patients with del(1p32.3) under thalidomide-based therapies were strongly associated with short progression-free survival (PFS) (median PFS 11.6 vs.31.2 months,P =0.002) and overall survival (OS) (median OS 16.8 vs.45.9 months,P < 0.001).Multivariate analysis revealed that del(1p32.3) remained a powerful independent factor with worse PFS (P =0.006) and OS (P =0.016) for patients under thalidomide-based treatments.Patients with del(1 p32.3) under bortezomib-based treatments tended to have short PFS and OS.In conclusion,del(1p32.3) is associated with short PFS and OS in patients with MM who received thalidomide-or bortezomib-based treatments.