EJHaem · 2025
Gain/Amplification 17p as a Potential Favorable Prognostic Factor in Multiple Myeloma: A Real-World Settings Retrospective Study.
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Wang Teng, Cui Siyuan, Wang Jingyi, Liu Zhaoxia, Liu Kui, Wang Zhenzhen, Tang Xinyu, Liu Di, Wang Yan, Xu Ruirong
Аннотация
BACKGROUND: Multiple myeloma (MM) is a genetically heterogeneous malignancy in which cytogenetic abnormalities critically influence prognosis. The prognostic significance of 17p gain/amplification (17p+), particularly relative to del(17p) and the high-risk 1q21 gain/amplification (1q21+), remains insufficiently defined.
METHODS: We retrospectively analyzed 125 MM patients treated at a single center between 2015 and 2024. Cytogenetic profiles were assessed using fluorescence in situ hybridization (FISH). Kaplan-Meier curves and Cox proportional hazards models evaluated the impact of 17p+ on progression-free survival 1 (PFS1), time to next treatment (TTNT), and overall survival (OS).
RESULTS: Compared with del(17p), 17p+ was associated with significantly longer PFS1 (HR 0.21, p < 0.01), TTNT (HR 0.18, p < 0.01), and OS (HR 0.25, p < 0.05). In patients receiving proteasome inhibitor-based therapy or not undergoing autologous stem cell transplantation, 17p+ remained favorable for PFS1 (HR 0.20, p < 0.05, HR 0.21, p < 0.01). Multivariate Cox models confirmed 17p+ as an independent protective factor for PFS1 (HR 0.08), TTNT (HR 0.07), and OS (HR 0.02) (all p < 0.001). Among patients with 1q21+, co-occurrence of 17p+ improved PFS1 (HR 0.47) and TTNT (HR 0.36) (p < 0.05), though no significant OS benefit was observed.
CONCLUSIONS: 17p+ is associated with markedly improved clinical outcomes in MM and may partially mitigate the adverse prognostic impact of 1q21+. These findings highlight the relevance of 17p+ in cytogenetic risk stratification and personalized treatment strategies and support further validation in multicenter cohorts.
TRIAL REGISTRATION: The authors have confirmed clinical trial registration is not needed for this submission.
METHODS: We retrospectively analyzed 125 MM patients treated at a single center between 2015 and 2024. Cytogenetic profiles were assessed using fluorescence in situ hybridization (FISH). Kaplan-Meier curves and Cox proportional hazards models evaluated the impact of 17p+ on progression-free survival 1 (PFS1), time to next treatment (TTNT), and overall survival (OS).
RESULTS: Compared with del(17p), 17p+ was associated with significantly longer PFS1 (HR 0.21, p < 0.01), TTNT (HR 0.18, p < 0.01), and OS (HR 0.25, p < 0.05). In patients receiving proteasome inhibitor-based therapy or not undergoing autologous stem cell transplantation, 17p+ remained favorable for PFS1 (HR 0.20, p < 0.05, HR 0.21, p < 0.01). Multivariate Cox models confirmed 17p+ as an independent protective factor for PFS1 (HR 0.08), TTNT (HR 0.07), and OS (HR 0.02) (all p < 0.001). Among patients with 1q21+, co-occurrence of 17p+ improved PFS1 (HR 0.47) and TTNT (HR 0.36) (p < 0.05), though no significant OS benefit was observed.
CONCLUSIONS: 17p+ is associated with markedly improved clinical outcomes in MM and may partially mitigate the adverse prognostic impact of 1q21+. These findings highlight the relevance of 17p+ in cytogenetic risk stratification and personalized treatment strategies and support further validation in multicenter cohorts.
TRIAL REGISTRATION: The authors have confirmed clinical trial registration is not needed for this submission.