Outcome according to cytogenetic abnormalities and DNA ploidy in myeloma patients receiving short induction with weekly bortezomib followed by maintenance

[EN]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...

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Detalles Bibliográficos
Autores: Mateos Manteca, María Victoria, Gutiérrez Gutiérrez, Norma Carmen, Martín-Ramos, María-Luisa, Lourenço Paiva, Bruno, Montalbán, María-Angeles, Oriol, Albert, Martínez-López, Joaquín, Teruel, Ana-Isabel, Bengoechea, Enrique, Martín, Alejandro, Díaz-Mediavilla, Joaquín, De Arriba, Felipe, Palomera, Luis, Hernández, José-Mariano, Sureda, Anna, Bargay, Joan, Peñalver, Francisco-Javier, Ribera Santasusana, Josép María, Martín-Mateos, María-Luisa, Fernández, Manuela, García Sanz, Ramón, Vidriales Vicente, María Belén, Bladé, Joan, Lahuerta, Juan-José, San Miguel Izquierdo, Jesús Fernando
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2011
País:España
Institución:Universidad de Salamanca (USAL)
Repositorio:GREDOS. Repositorio Institucional de la Universidad de Salamanca
OAI Identifier:oai:gredos.usal.es:10366/154309
Acceso en línea:http://hdl.handle.net/10366/154309
Access Level:acceso abierto
Palabra clave:Mieloma múltiple
Chromosome Aberrations
Aged
Boronic Acids
Induction Chemotherapy
DNA
Drug Administration Schedule
Humans
Pyrazines
Algorithms
Antineoplastic Combined Chemotherapy Protocols
Prognosis
Multiple Myeloma
Maintenance Chemotherapy
Time Factors
Treatment Outcome
Ploidies
protocolos de quimioterapia antineoplásica combinada
humanos
factores de tiempo
anciano
algoritmos
mieloma múltiple
pauta de administración medicamentosa
quimioterapia de inducción
pronóstico
ácidos borónicos
resultado del tratamiento
ADN
quimioterapia de mantenimiento
aberraciones cromosómicas
piracinas
ploidía
Descripción
Sumario:[EN]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.

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