The Influence Of Cytogenetic Abnormalities,clinical Features And Chemotherapy Regimens On The Prognosis Of Newly Diagnosed Multiple Myeloma

Objective:To investigate the influence of common cytogenetic abnormalities on newly diagnosed multiple myeloma(MM)patients with PFS,to study the relationship between clinical features and PFS,and to explore the effect of different chemotherapy regimens on prognosis.METHODS:The clinical data of 37 newly diagnosed multiple myeloma patients who were admitted to the Department of Hematology,Wanjishan Hospital,Wannan Medical College from January 2014 to December 2017 were collected,and five specific probes were used including:RB1 deletion,D13S319 Deletion,1q21 amplification,IgH ectopicity,p53 deletion,FISH detection of the bone marrow of 37 newly diagnosed patients with multiple myeloma,at least 2-4 courses after the evaluation of efficacy,to explore the common cytogenetic abnormalities and Relationship between PFS.Among them,37 patients were grouped according to their willingness to receive different chemotherapy regimens.They were divided into the conventional chemotherapy group and the chemotherapy group with bortezomib(a proteasome inhibitor)and thalidomide(a immunomodulatory agent)as the basic protocol(hereinafter referred to as the Borax chemotherapy group).The two groups were statistically analyzed for PFS and ORR,and their relationship with prognosis was analyzed.Data was analyzed using SPSS 17.0 software.RESULTS:1.FISH results in 37 patients showed that chromosome abnormalities were detected in 51.3%(19/37).The incidence of chromosomal abnormalities was high-low,14 cases(37.8%)were amplified by 1q21,and 12 cases(32.4%)were missing by RB1.IgH rearrangements occurred in 11 cases(28.9%),D13S319 was absent in 10 cases(27.0%),and p53 was absent in 7 cases(18.9%).1q21 and p53 affected the median time of PFS and PFS.The difference was statistically significant,with P values of 0.009 and 0.05,respectively.2.Based on a series of clinical features of 37 patients including age,sex,leukocyte,hemoglobin,platelet,creatinine,albumin,serum calcium ion concentration,lactate dehydrogenase,bone marrow cytology analysis,and blood β2 microglobulin Comparing patients’ prognosis,univariate analysis found that creatinine>115umol/L,hemoglobin<85g/L,and albumin<3 5g/L shortened PFS,which was a poor prognostic factor(P<0.05).Blood(32 microglobulin(P=0.057)also has a poor prognosis.Combined with univariate analysis,a multivariate analysis of albumin<35 g/L was an independent adverse prognostic factor.3.After the 2-4 courses of treatment,PFS and ORR were compared between the conventional chemotherapy group and the bortezomib-and thalidomide-based chemotherapy group.The PFS and ORR of the new drug group were higher than the conventional group,P=0.001,difference Statistically significant.In the conventional chemotherapy group,the normal and abnormal FISH were 3 cases and 9 cases respectively,and the ORR was 33.3%and 22.2%respectively.The normal and abnormal FISH of the Borax chemotherapy group was 15 cases and 10 cases respectively,and the ORR was 93.3%and 80.0%respectively.Conclusion:1.The median time for PFS in patients with MM with 1q21 amplification and p53 deletion was decreased by FISH.2.The univariate analysis showed that PFS was shortened in patients with creatinine>115 umol/L,hemoglobin<85g/L,and albumin<35g/L.Multivariate analysis of albumin<35 g/L was an independent adverse prognostic factor.3.The chemotherapy based on bortezomib and thalidomide can significantly improve the prognosis.PFS can be significantly prolonged,ORR can be significantly improved,and the curative effect can be significantly improved compared with conventional chemotherapy,which can improve the efficacy of cytogenetic abnormalities.