Clinical characteristics and treatment outcomes of newly diagnosed multiple myeloma with chromosome 1q abnormalities

Nadine Abdallah, Patricia Greipp, Prashant Kapoor, Morie A. Gertz, Angela Dispenzieri, Linda B. Baughn, Martha Q. Lacy, Suzanne R. Hayman, Francis K. Buadi, David Dingli, Ronald S. Go, Yi L. Hwa, Amie Fonder, Miriam Hobbs, Yi Lin, Nelson Leung, Taxiarchis Kourelis, Rahma Warsame, Mustaqeem Siddiqui, John LustRobert A. Kyle, Leif Bergsagel, Rhett Ketterling, S. Vincent Rajkumar, Shaji K. Kumar

Research output: Contribution to journalArticlepeer-review

Abstract

A gain in chromosome 1q (+1q) is among the most common cytogenetic abnormalities in multiple myeloma (MM). It is unclear whether +1q is independently associated with decreased overall survival (OS). The objective of this study was to evaluate the impact of +1q on clinical characteristics, treatment response, and survival outcomes. We included 1376 Mayo Clinic patients diagnosed with MM from 2005 to 2018 who underwent fluorescence in situ hybridization testing at diagnosis with a panel including the +1q probe. A gain in 1q was found in 391 patients (28%) and was associated with anemia, hypercalcemia, high tumor burden, International Staging System (ISS) stage 3, high-risk (HR) translocations, and chromosome 13 abnormalities. There was no difference in overall response or deeper responses to proteasome inhibitor (PI)-, immunomodulatory drug (iMiD)-, or PI plus IMiD-based induction. Time to next treatment was shorter in patients with +1q compared with those without +1q (19.9 vs 27.7 months; P < .001). On univariate analysis, +1q was associated with increased risk of death (risk ratio [RR], 1.9; P < .001), and decreased OS was seen in all treatment groups. +1q was independently associated with decreased OS on multivariate analysis when other HR cytogenetic abnormalities, ISS stage 3, and age ≥70 years were included (RR, 1.5; P < .001). Gain of >1 copy of 1q was not associated with worse OS compared with gain of 1 copy (4.9 vs 4.3 years; P = .21). +1q was associated with high tumor burden, advanced disease stage, and HR translocations. It is independently associated with decreased OS, even in the setting of novel therapy and transplant.

Original languageEnglish (US)
Pages (from-to)3509-3519
Number of pages11
JournalBlood Advances
Volume4
Issue number15
DOIs
StatePublished - Aug 11 2020

ASJC Scopus subject areas

  • Hematology

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