The Significance Of 1q21 Amplification In The Diagnosis And Therapy Of Multiple Myeloma

Objective To analyze the correlation between cytogenetic abnormalities(including 1q21 amplification,RB1 and D13S319 deletion, p53 deletion and rearrangement of IGH) and clinical manifestations of multiple myeloma(MM) patients, as well as the significance of 1q21 amplification in the risk-adapted therapy, in order to evaluate clinical application value of cytogenetic abnormalities.Methods Retrospective analysis was used. Clinical materials of 60 newly diagnosed MM patients were collected and risks were stratified based on these data, in order to evaluate the correlation between 1q21 amplification with clinical manifestations, risk stratification and the influence of 1q21 amplification on the therapeutic regimens and effect. In addition, the correlation between the rest cytogenetic abnormalities and clinical features of MM was analyzed.Results(1)1q21 amplification and ISS staging, anemia, hypo-albuminemia, β2 –MG level had a correlation(P value respectively was 0.036,0.034,0.023,0.034);RB1 and D13S319 abnormalities were significantly related to hypo-albuminemia(P=0.021) and hypercalcemia(P=0.049);P53 deletion had a relation with sexuality(P=0.046) and hypercalcemia(P=0.045);there was no relation between IGH rearrangement and clinical features of MM.(2) 1q21 amplification related the risk strafication remarkably(P=0.008);(3) The overall response rates of new drugs treatment and traditional chemotherapy were 90%,63.3%,and the difference between them had statistical significance(P=0.015);(4) In low-risk group, the difference of overall response rate in 1q21 amp positive and negative patients had statistical significance(P=0.008);In 1q21 amplification positive patients of high-risk group, the difference of overall response rate of new drugs treatment and traditional chemotherapy also had statistical significance(P=0.039);Conclusion1. The detection rate of 1q21 amplification in MM patients with anemia was higher than those without anemia; the patients with hypo-albuminemia had a higher detection rate of 1q21 amplification, RB1 and D13S319 deletion; in patients with hypercalcemia, the detection rates of deletion of RB1,D13S319 and P53 were higher; the female patients had a higher detection rate of P53 deletion than male ones.2. In high-risk group, the detection rate of 1q21 amplification positive is higher.3. The patients received new drugs had a better outcome than ones treated with traditional chemotherapy.4. In the high-risk group, the patients with 1q21 amplification could profit from using new drugs compared to traditional chemotherapy; however, the treatment outcome had no difference in patients without 1q21 amplification whether new drugs were used.5. In low-risk group 1q21 amp negative patients can get a better outcome. New drugs and traditional chemotherapy had no influence on the treatment outcome.