伴t(14;16)的初治多发性骨髓瘤19例预后分析  

Prognostic analysis of 19 newly treated multiple myeloma patients with t(14;16)

作　　者：李叶 刘俊茹[3] 李娟[3] 陈文明[1] Li Ye;Liu Junru;Li Juan;Chen Wenming(Department of Hematology,Beijing Chaoyang Hospital,Capital Medical University,Myeloma Research Center of Beijing,Beijing 100020,China;Peking University People's Hospital,Peking University Institute of Hematology,National Clinical Research Center for Hematologic Disease,Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for Hematological Diseases,Beijing 100044,China;Department of Hematology,The First Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510080,China)

机构地区：[1]首都医科大学附属北京朝阳医院血液科北京市多发性骨髓瘤医疗研究中心,北京100020 [2]北京大学人民医院,北京大学血液病研究所,国家血液系统疾病临床医学研究中心,造血干细胞移植治疗血液病北京市重点实验室,北京100044 [3]中山大学附属第一医院血液科,广州510080

出　　处：《中华血液学杂志》2024年第10期944-950,共7页Chinese Journal of Hematology

摘　　要：目的探讨伴t(14;16)初治多发性骨髓瘤(MM)患者的预后。方法收集2018年1月至2020年11月首都医科大学附属北京朝阳医院和中山大学附属第一医院564例初治MM患者的临床资料并进行回顾性分析,比较伴t(14;16)患者与FISH正常、伴t(4;14)、伴del(17p)患者的预后。结果564例初治MM患者中19例(3.4%)伴t(14;16)异常,其中14例合并1q21+,3例合并del(17p)。与FISH正常的患者相比,t(14;16)患者具有较短的无进展生存(PFS)期和总生存(OS)期(中位PFS期分别为14个月和未达到,P<0.001;中位OS期分别为42个月和未达到,P=0.002)。倾向性评分匹配后的15例伴t(14;16)和15例伴t(4;14)患者PFS期和OS期的差异均无统计学意义(中位PFS期分别为13.0个月和未达到,P=0.247;中位OS期分别为42个月和未达到,P=0.609)。倾向性评分匹配后的15例伴t(14;16)和15例伴del(17p)患者PFS期和OS期的差异均无统计学意义(中位PFS期分别为13个月和31个月,P=0.939;中位0S期分别为42个月和37.3个月,P=0.557)。同时合并1q21+时,倾向性评分匹配后的伴t(14;16)患者与伴t(4;14)、伴del(17p)患者PFS期和OS期的差异均无统计学意义(P值均>0.05)。伴t(14;16)患者是否进行auto-HSCT对PFS和OS均无明显影响(P值均>0.05)。结论在初治MM患者中,t(14;16)常伴随其他高危细胞遗传学异常出现,其不良预后价值与t(4;14)及del(17p)相似。Objective To investigate the prognosis of newly diagnosed multiple myeloma(MM)patients with t(14;16)abnormality.Methods Clinical data from 564 patients diagnosed with initial MM from January 2018 to November 2020 at Beijing Chaoyang Hospital affiliated with Capital Medical University and the First Affiliated Hospital of Sun Yat-sen University were collected and retrospectively analyzed.The prognoses of patients with t(14;16)were analyzed and compared with the prognoses of patients with normal FISH,and those with t(4;14)and del(17p).Results Among 564 newly diagnosed MM patients,19(3.4%)exhibited t(14;16)abnormalities,with 14 cases diagnosed with 1q21+and three cases with del(17p).Progression-free survival(PFS)and overall survival(OS)of patients with t(14;16)were significantly shorter compared with patients with normal FISH(the median PFS:14 months vs not reached,P<0.001;the median OS:42 months vs not reached,P=0.002).No statistically significant difference was detected in PFS and OS between the 15 patients with t(14;16)and the 15 with t(4;14)after propensity score matching (the median PFS: 13.0 months vs not reached, P=0.247;the median OS: 42months vs not reached, P=0.609). Similarly, no statistically significant difference was observed in PFS andOS between 15 patients with t(14;16) and 15 with del(17p)(the median PFS: 13 months vs 31 months, P=0.939;the median OS: 42 months vs 37.3 months, P=0.557). Propensity score matching indicated thatwhen combined with 1q21+, no statistically significant differences were present in PFS and OS betweenpatients with t(14;16) and patients with t(4;14) or patients with del(17p)(all P>0.05). Whether or notthe patients with t( 14;16) had undergone auto-HSCT did not significantly impact the PFS and OS(all P>0.05). Conclusiont (14;16) is often associated with high-risk cytogenetic abnormalities in newlydiagnosed MM patients, and its adverse prognostic value is similar to that of t( 4;14) and del( 17p).

关 键 词：多发性骨髓瘤 预后 t(14 16) 细胞遗传学 

分 类 号：R733.3[医药卫生—肿瘤]