期刊
INTERNATIONAL JOURNAL OF HEMATOLOGY
卷 113, 期 2, 页码 207-213出版社
SPRINGER JAPAN KK
DOI: 10.1007/s12185-020-03005-6
关键词
Multiple myeloma; t(4; 14) translocation; Novel drugs; Daratumumab; Prognosis; Overall survival; Overall response rate
类别
Translocation t(4;14) is an independent prognostic factor associated with adverse outcomes in multiple myeloma, and it is specifically linked to the IgA isotype. Patients with t(4;14) have lower overall survival rates, although progression-free survival does not differ significantly.
Translocation t(4;14) is an independent prognostic factor for adverse outcome in multiple myeloma (MM). However, reports concerning the therapeutic effects of novel drugs on t(4;14) MM are few. We retrospectively investigated the clinical and prognostic significance of symptomatic MM cases with t(4;14) treated with novel therapies. Ninety-three patients (IgG, 56; IgA, 23; BjP, 14) newly diagnosed with MM were included (median age, 71 years; median observation period, 27.8 months). t(4;14) MM was diagnosed in 17 (IgG, 7; IgA, 9; BjP, 1) patients (18%). An association between t(4;14) and the IgA isotype was confirmed (p = 0.02). Overall survival (OS) at 3 years was lower in the t(4;14) patients than without t(4;14) group (81.2% vs 66.7%,p = 0.04). Multivariate analysis showed that t(4;14) was an independent predictor of OS (hazard ratio [HR], 7.58; 95.0% confidence interval [CI], 1.43-39.9;p = 0.0017). The ORR after autologous blood stem cell transplantation (ASCT) did not differ with or without t(4;14); progression-free survival tended to be prolonged in the group without t(4;14) (p = 0.088). Thus, even in the era of novel drugs, t(4;14) MM still has a poor prognosis, and triplet consolidation therapy should be continued.
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