Chromosome 13 deletion and hypodiploidy on conventional cytogenetics are robust prognostic factors in Korean multiple myeloma patients: web-based multicenter registry study
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- 作者：Sukjoong Oh (1)
Dong Hoe Koo (1)
Min-Jung Kwon (2)
Kihyun Kim (3)
Cheolwon Suh (4)
Chang-Ki Min (5)
Sung-Soo Yoon (6)
Ho-Jin Shin (7)
Deog-Yeon Jo (8)
Jae-Yong Kwak (9)
Jin Seok Kim (10)
Sang Kyun Sohn (11)
Young-Don Joo (12)
Hyeon-Seok Eom (13)
Sung-Hyun Kim (14)
Yang Soo Kim (15)
ChulSoo Kim (16)
Yeung-Chul Mun (17)
Hawk Kim (18)
Dong Soon Lee (19)
Jae Hoon Lee (20) - 关键词：Multiple myeloma ; Cytogenetic Analysis ; Prognosis
- 刊名：Annals of Hematology
- 出版年：2014
- 出版时间：August 2014
- 年：2014
- 卷：93
- 期：8
- 页码：1353-1361
- 全文大小：456 KB
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Dong Hoe Koo (1)
Min-Jung Kwon (2)
Kihyun Kim (3)
Cheolwon Suh (4)
Chang-Ki Min (5)
Sung-Soo Yoon (6)
Ho-Jin Shin (7)
Deog-Yeon Jo (8)
Jae-Yong Kwak (9)
Jin Seok Kim (10)
Sang Kyun Sohn (11)
Young-Don Joo (12)
Hyeon-Seok Eom (13)
Sung-Hyun Kim (14)
Yang Soo Kim (15)
ChulSoo Kim (16)
Yeung-Chul Mun (17)
Hawk Kim (18)
Dong Soon Lee (19)
Jae Hoon Lee (20)
1. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, South Korea
2. Department of Laboratory medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, South Korea
3. Department of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
4. Department of Oncology, Asan Medical Center, University of Ulsan, Seoul, South Korea
5. Department of Internal Medicine, Seoul St. Mary’s Hospital, Catholic University of Korea, Seoul, South Korea
6. Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
7. Department of Hematology/Oncology, Pusan National University Hospital, Busan, South Korea
8. Department of Internal Medicine, Chungnam National University Hospital, Daejeon, South Korea
9. Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, South Korea
10. Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
11. Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
12. Department of Internal Medicine, Haeundae Paik Hospital, Inje University, Busan, South Korea
13. Hematology-Oncology Clinic, National Cancer Center, Goyang-si, South Korea
14. Department of Internal Medicine, Dong-A Medical Center, Dong-A University College of Medicine, Busan, South Korea
15. Department of Internal Medicine, Kosin University Gospel Hospital, Busan, South Korea
16. Comprehensive Cancer Center, Inha University Hospital, Incheon, South Korea
17. Department of Internal Medicine, Ewha Woman’s University School of Medicine, Seoul, South Korea
18. Department of Internal Medicine, Ulsan University Hospital, Ulsan, South Korea
19. Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
20. Department of Internal Medicine, Gachon University Gil Hospital, 1198 Guwol-dong, Namdong-gu, Incheon, 405-220, South Korea - ISSN：1432-0584
文摘
This study was designed to evaluate the prevalence of chromosomal abnormalities and to identify the specific abnormalities associated with poor prognosis. A total of 2,474 patients whose conventional cytogenetics were available at the time of diagnosis were evaluated via a nationwide registry. Normal metaphase cytogenetics was observed in 2,012 patients (81.3%). Among the 462 patients with chromosomal abnormalities, there were 161 (34.8%) patients with hyperdiploidy, 197 (42.6%) with pseudodiploidy, 79 (17.1%) with hypodiploidy, and 25 (5.5%) with near-tetraploidy. Deletion 13 (Δ13) in metaphase was observed in 167 patients (6.8%). Fluorescent in situ hybridization (FISH) was carried out in 967 patients (39.1%), and 66 (13.7%) out of 482 and 63 (10.3%) out of 611 patients were positive for t(4;14) and del(17p), respectively. With a median follow-up duration of 25.1 months, the median overall survival (OS) was 51.2 months (95% confidence interval, 46.5-5.9 months). In univariate analysis, the following four chromosomal abnormalities were significantly associated with a poor survival outcome: Δ13, hypodiploidy, del(13q) in FISH, and del(17p) in FISH. In the subsequent multivariate analysis, in which del(13q) and del(17p) in FISH were excluded due to a relatively low number of patients, Δ13 and hypodiploid status were independently associated with a poor survival outcome after adjusting for important clinical factors, including age, sex, performance, beta2-microglobulin, albumin, and lactate dehydrogenase (LDH). Using conventional metaphase cytogenetics, we confirmed that both Δ13 and hypodiploid status were robust poor prognostic factors. The metaphase karyotyping should remain the primary cytogenetic tool and an essential investigation for risk stratification in newly diagnosed multiple myeloma patients.