Impact of 1q21 amplification on prognosis and treatment effect of multiple myeloma

Objective To investigate the value of 1q21 amplification in newly diagnosed myeloma patients. Methods Fifty-two cases of newly diagnosed multiple myeloma from June 2008 to June 2010 were enrolled. Fluorescence in situ hybridization(FISH)was used to detect the 1q21 amplification, and the clinical characteristics and treatment response were analyzed. Results 1q21 amplification was discovered in 30 of 52 patients(57.7 %), Clinical characteristics such as gender, malignant pleural effusion, extramedullary plasmacytoma, bone destruction, β2 microglobulin, ALB, hemoglobin, blood calcium, plasma cell proportion, clinical stage seemed to have no correlation with 1q21 amplification. The 52 patients all received bortezomib-based regimens. The response rates were not significant difference between patients with and without 1q21 amplification, the OS was also not significant difference [26 months(6-30 months)vs 30 months(12-85 months), P= 0.409], but the patients with presence of 1q21 gain resulted in significantly shorter PFS [8 months(1-30 months)vs 20 months(3-48 months), P= 0.019]. Multivariate analysis showed 1q21 with more than two additional genetic abnormalities was an independent prognostic predictor(P= 0.031). Conclusion 1q21 amplification is one of the adverse prognostic predictors, the response rate is not significant difference between patients with and without 1q21 amplification in bortezomib-based group, but the 1q21 amplification could result in significantly shortened PFS. Key words: Multiple myeloma; 1q21 amplification; Prognosis