Proposed risk‐scoring model for estimating the prognostic impact of 1q gain in patients with newly diagnosed multiple myeloma

作者：Pei‐Yu Yang, Haimin Chen, Xinyue Liang, Weiling Xu, Shanshan Yu, Wenyang Huang, Xingcheng Yi, Qiang Guo, Mengru Tian, Tingting Yue, Mengyao Li, Yingjie Zhang, Mengxue Zhang, Yurong Yan, Zhongli Hu, Shaji Kumar, Fan Zhou, Yun Dai, Fengyan Jin · 发表于：American Journal of Hematology · 年份：2022 · DOI：10.1002/ajh.26774 · 被引用次数：17 · 研究领域：Multiple Myeloma Research and Treatments、Protein Degradation and Inhibitors、Peptidase Inhibition and Analysis

1q gain (+1q) is the most common high-risk cytogenetic abnormality (HRCA) in patients with multiple myeloma (MM). However, its prognostic value remains unclear in the era of novel agents. Here, we retrospectively analyzed the impact of +1q on the outcomes of 934 patients newly diagnosed with MM. +1q was identified in 53.1% of patients and verified as an independent variate for inferior overall survival (OS) (hazard ratio, 1.400; 95% confidence interval, 1.097-1.787; p = .007). Concurrence of other HRCAs (particularly t(14;16) and del(17p)) further exacerbated the outcomes of patients with +1q, suggesting prognostic heterogeneity. Thus, a risk-scoring algorithm based on four risk variates (t(14;16), hypercalcemia, ISS III, and high LDH) was developed to estimate the outcomes of patients with +1q. Of the patients, 376 evaluable patients with +1q were re-stratified into low (31.6%), intermediate (61.7%), and high risk (6.7%) groups, with significantly different progression-free survival and OS (p < .0001), in association with early relapse of the disease. The prognostic value of this model was validated in the CoMMpass cohort. While attaining undetectable MRD largely circumvented the adverse impact of +1q, it scarcely ameliorated the outcome of the patients with high risk, who likely represent a subset of patients with extremely poor survival. Hence, patients with +1q are a heterogeneous group of high-risk patients, therefore underlining the necessity for their re-stratification...