title: Outcome according to cytogenetic abnormalities and DNA ploidy in myeloma patients receiving short induction with weekly bortezomib followed by maintenance.
abstract: Cytogenetic abnormalities (CAs) such as t(4;14), t(14;16) or del(17p), and nonhyperdiploidy are associated with poor prognosis in multiple myeloma. We evaluated the influence of CAs by FISH and DNA ploidy by flow cytometry on response and survival in 232 elderly, newly diagnosed multiple myeloma patients receiving an induction with weekly bortezomib followed by maintenance therapy with bortezomib-based combinations. Response was similar in the high-risk and standard-risk CA groups, both after induction (21% vs 27% complete responses [CRs]) and maintenance (39% vs 45% CR). However, high-risk patients showed shorter progression-free survival (PFS) than standard-risk patients, both from the first (24 vs 33 months; P = .04) and second randomization (17 vs 27 months; P = .01). This also translated into shorter overall survival (OS) for high-risk patients (3-year OS: 55% vs 77%; P = .001). This adverse prognosis applied to either t(4;14) or del(17p). Concerning DNA ploidy, hyperdiploid patients showed longer OS than nonhyperdiploid patients (77% vs 63% at 3 years; P = .04), and this was more evident in patients treated with bortezomib, thalidomide, and prednisone (77% vs 53% at 3 years; P = .02). The present schema does not overcome the negative prognosis of high-risk CAs and nonhyperdiploidy. This trial was registered with www.ClinicalTrials.gov as NCT00443235.
authors: University Hospital of Salamanca, Salamanca, Spain. mvmateos@usal.es
authors: María-Victoria
authors: MV
authors: Mateos
authors: Norma C
authors: NC
authors: Gutiérrez
authors: María-Luisa
authors: ML
authors: Martín-Ramos
authors: Bruno
authors: B
authors: Paiva
authors: María-Angeles
authors: MA
authors: Montalbán
authors: Albert
authors: A
authors: Oriol
authors: Joaquín
authors: J
authors: Martínez-López
authors: Ana-Isabel
authors: AI
authors: Teruel
authors: Enrique
authors: E
authors: Bengoechea
authors: Alejandro
authors: A
authors: Martín
authors: Joaquín
authors: J
authors: Díaz-Mediavilla
authors: Felipe
authors: F
authors: de Arriba
authors: Luis
authors: L
authors: Palomera
authors: José-Mariano
authors: JM
authors: Hernández
authors: Anna
authors: A
authors: Sureda
authors: Joan
authors: J
authors: Bargay
authors: Francisco-Javier
authors: FJ
authors: Peñalver
authors: Josep-Maria
authors: JM
authors: Ribera
authors: María-Luisa
authors: ML
authors: Martín-Mateos
authors: Manuela
authors: M
authors: Fernández
authors: Ramón
authors: R
authors: García-Sanz
authors: María-Belén
authors: MB
authors: Vidriales
authors: Joan
authors: J
authors: Bladé
authors: Juan-José
authors: JJ
authors: Lahuerta
authors: Jesús F
authors: JF
authors: San Miguel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001897:Boronic Acids / Q000008:administration & dosage*; D000069286:Bortezomib; D002869:Chromosome Aberrations; D004273:DNA, Neoplasm / Q000235:genetics; D004334:Drug Administration Schedule; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods; D060046:Maintenance Chemotherapy / Q000379:methods; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000188:drug therapy* / Q000235:genetics; D011003:Ploidies; D011379:Prognosis; D011719:Pyrazines / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001897:Boronic Acids; D004273:DNA, Neoplasm; D011719:Pyrazines; D000069286:Bortezomib