Cancer medicine · 2025
Navigating the Prognostic Complexity of IgH Cytogenetic Abnormalities in Multiple Myeloma Among Diverse IgH Cytogenetic Abnormalities-Involved High-Risk Stratifications.
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Xiong Yanqiu, Li Meng, Li Yan, Tang Wenjiao, Dong Tian, Xiang Bing, Zhang Li, Pan Ling, Niu Ting
Аннотация
OBJECTIVE: To evaluate the clinical and prognostic significance of immunoglobulin heavy chain (IgH) cytogenetic abnormalities in patients with newly diagnosed multiple myeloma (NDMM) and explore their association with other high-risk cytogenetic features.
PATIENTS AND METHODS: We retrospectively analyzed 503 NDMM patients treated between February 1, 2016, and February 29, 2024. Cytogenetic abnormalities were identified by fluorescence in situ hybridization.
RESULTS: The study uncovered a significant correlation between IgH cytogenetic abnormality and an increased prevalence of anemia (p < 0.001), thrombocytopenia (p = 0.005), and the presence of high-risk cytogenetic aberrations, including +1q21 (p < 0.001) and P53 deletion (p = 0.001). Patients afflicted with IgH cytogenetic abnormality were found to have more advanced stages of the disease, as indicated by higher Disease Stage (p < 0.001), International Staging System (p = 0.018), Revised International Staging System (RISS) (p < 0.001), and Second Revision of the International Staging System (p < 0.001). This cytogenetic abnormality was also linked to a markedly diminished progression-free survival (PFS) across RISS I-II, yet autologous stem cell transplantation (ASCT) offered significant improvement for PFS (p < 0.05). Notably, the specific t(14;16) and t(14; undefined) were significantly associated with shorter PFS (p < 0.001) and shorter overall survival (OS) (p < 0.05). Additionally, the confluence of IgH cytogenetic abnormality with other cytogenetic abnormalities, particularly +1q21, P53 deletion, RB/D13S319 deletion, and elevated LDH level, was found to exacerbate the disease outcome.
CONCLUSION: IgH cytogenetic abnormalities indicate aggressive disease and poorer survival in NDMM, especially when accompanied by other high-risk markers. ASCT may mitigate these adverse outcomes, supporting its role in individualized treatment strategies.
PATIENTS AND METHODS: We retrospectively analyzed 503 NDMM patients treated between February 1, 2016, and February 29, 2024. Cytogenetic abnormalities were identified by fluorescence in situ hybridization.
RESULTS: The study uncovered a significant correlation between IgH cytogenetic abnormality and an increased prevalence of anemia (p < 0.001), thrombocytopenia (p = 0.005), and the presence of high-risk cytogenetic aberrations, including +1q21 (p < 0.001) and P53 deletion (p = 0.001). Patients afflicted with IgH cytogenetic abnormality were found to have more advanced stages of the disease, as indicated by higher Disease Stage (p < 0.001), International Staging System (p = 0.018), Revised International Staging System (RISS) (p < 0.001), and Second Revision of the International Staging System (p < 0.001). This cytogenetic abnormality was also linked to a markedly diminished progression-free survival (PFS) across RISS I-II, yet autologous stem cell transplantation (ASCT) offered significant improvement for PFS (p < 0.05). Notably, the specific t(14;16) and t(14; undefined) were significantly associated with shorter PFS (p < 0.001) and shorter overall survival (OS) (p < 0.05). Additionally, the confluence of IgH cytogenetic abnormality with other cytogenetic abnormalities, particularly +1q21, P53 deletion, RB/D13S319 deletion, and elevated LDH level, was found to exacerbate the disease outcome.
CONCLUSION: IgH cytogenetic abnormalities indicate aggressive disease and poorer survival in NDMM, especially when accompanied by other high-risk markers. ASCT may mitigate these adverse outcomes, supporting its role in individualized treatment strategies.