Cancer. 2011 May 15;117(10):2136-44. doi:
10.1002/cncr.25775. Epub 2010 Dec 4.
Chromosomal aberrations +1q21 and
del(17p13) predict survival in patients with
recurrent multiple myeloma treated with lenalidomide
and dexamethasone.
Klein U, Jauch A, Hielscher T, Hillengass J,
Raab MS, Seckinger A, Hose D, Ho AD, Goldschmidt
H, Neben K.
Department of Internal Medicine V, University of
Heidelberg, Heidelberg, Germany.
Abstract
BACKGROUND:
In the era of novel agents such as
lenalidomide and bortezomib, risk stratification
by chromosomal abnormalities may enable a more
rational selection of therapeutic approaches in
patients with multiple myeloma (MM).
METHODS:
The authors analyzed the prognostic value of
deletion del(13q14), del(17p13), +1q21,
translocation t(4;14), t(11;14), and t(14;16) by
fluorescence in situ hybridization (FISH) in a
series of 92 patients with recurrent MM who were
treated with lenalidomide and dexamethasone (len/dex)
at the study center.
RESULTS:
Patients carrying del(13q14) or t(14;16) were
found to have a shorter median time to disease
progression (TTP) of 5.1 months (vs 14.4 months;
P = .009) and 2.0 months (vs 10.5 months; P
<.001), respectively. However, no effect on TTP
was observed in patients harboring del(13q14) as
an exclusive chromosomal aberration without the
concomitant presence of t(4;14) or del(17p13).
The median overall survival (OS) for patients
with del(17p13) or +1q21 was 6.7 months (P =
.002) and 8.3 months (P < .001), respectively,
whereas the median OS for patients carrying none
of these abnormalities was not reached.
Multivariate analysis revealed that the effects
of del(17p13) and +1q21 on OS were independent
of patient age as well as the type and number of
regimens administered before len/dex.
CONCLUSIONS:
The results of the current study suggest that
the prognostic significance of t(4;14) may be
ameliorated or eliminated in patients treated
with len/dex, whereas the presence of del(17p13)
or +1q21 is still associated with a dismal OS.
The presence of t(11;14) and del(13q14) as
exclusive chromosomal aberrations indicates no
impact on outcome. Because of its rarity in MM,
a confirmation of the prognostic role of the
t(14;16) aberration is still pending.
2010 American Cancer Society.
- PMID: 21523726 [PubMed - in process]