Chromosome 1q Abnormalities in Patients With Myeloma: Predictive of Inferior Outcomes?
Posted: Friday, September 18, 2020
Consistent with the results of previous studies, a recent retrospective study reported chromosome 1q abnormalities were found in nearly 30% of patients with multiple myeloma, along with an association with anemia, thrombocytopenia, hypercalcemia, markers of high tumor burden, and an advanced stage of the disease. Shaji K. Kumar, MD, of the Mayo Clinic, Rochester, Minnesota, and colleagues, who published their findings in Blood Advances, found this gain in chromosome 1q also was linked with decreased overall survival, independent of other high-risk cytogenetic abnormalities, disease stage, and age.
“An important finding of the study was the similar rates and magnitude of response in patients harboring extra copy/copies of 1q compared with those without 1q gain, indicating those with 1q gain respond well to therapy, but the responses are not durable, as suggested by a shorter time to next therapy,” coauthor Prashant Kapoor, MD, also of the Mayo Clinic, told JNCCN 360. “The currently used front-line therapies are unable to overcome the adverse prognostic impact of 1q gain/amplification, and clinical trials specifically focusing on patients with 1q gain are warranted.”
A total of 1,376 patients diagnosed with multiple myeloma at the Mayo Clinic between 2005 and 2018 were the focus of the study. A gain in 1q was identified in 28% of patients (n = 391), with an association with anemia, hypercalcemia, high tumor burden, International Staging System (ISS) stage 3, high-risk translocations, and chromosome 13 abnormalities. Treatment regimens included a proteasome inhibitor, an immunomodulatory agent, or a combination of both.
Based on univariate analysis, the investigators found that a gain in 1q was associated with an increased risk of death (risk ratio = 1.9; P < .001), along with decreased overall survival in all treatment groups. Based on multivariate analysis, a gain in 1q was independently linked to decreased overall survival when three other factors were included: high-risk cytogenetic abnormalities, ISS stage 3, and age of 70 or older (relative risk = 1.5; P < .001). However, the study authors noted, there appeared to be no association with worse overall survival with gain of > 1 copy of 1q compared with gain of 1 copy (4.9 years vs. 4.3 years; P = .21).
Disclosure: For full disclosures of the study authors, visit ashpublications.org.