Gain of chromosome 1q portends worse prognosis in multiple myeloma despite novel agent-based induction regimens and autologous transplantation

Leuk Lymphoma. 2017 Aug;58(8):1823-1831. doi: 10.1080/10428194.2016.1260126. Epub 2017 Jan 12.

Abstract

We aimed to identify whether the use of autologous hematopoietic cell transplantation (HCT) impacts outcomes for multiple myeloma patients with gains of chromosome 1q (+1q). We retrospectively identified 95 patients, 21% having +1q. For patients with +1q, the overall response rate to induction was 85%, with 40% having ≥ VGPR and 20% achieving a CR, similar to non +1q patients (p = .64). The median PFS from diagnosis with +1q was 2.1 years (95% CI: 1.2-not reached (NR)) vs 4.3 years (95% CI: 3.3 yrs-NR) without +1q (p = .003). Median OS from diagnosis was 4.4 years (95% CI: 2.9-NR) vs not reached, respectively (p = .005). On molecular analysis using the Foundation One Heme assay, the most common mutations seen in +1q patients included TP53 (38%) and KRAS (25%). Overall, gain of 1q portends worse PFS and OS which was not negated by auto HCT. Such patients will likely require additional therapy to improve their survival.

Keywords: Neoplasia; clinical results; marrow and stem cell transplantation; myeloma; neoplasia – cytogenetics; neoplasia – molecular genetics.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chromosome Duplication*
  • Chromosomes, Human, Pair 1*
  • Combined Modality Therapy
  • Female
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Immunoglobulin Isotypes / blood
  • In Situ Hybridization, Fluorescence
  • Male
  • Middle Aged
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / genetics*
  • Multiple Myeloma / mortality*
  • Multiple Myeloma / therapy
  • Neoplasm Staging
  • Prognosis
  • Remission Induction
  • Survival Analysis
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Immunoglobulin Isotypes