Blood:del(17p)指示多发性骨髓瘤患者预后不良

2020-11-04 星云 MedSci原创

中心点:

中心点:

Del(17p)是骨髓瘤的重要预后因子,即使没有TP53突变的存在。

孤立性del(17p)应该还是作为骨髓瘤的高风险特征。

摘要:

虽然在过去的十年里,多发性骨髓瘤(MM)患者的预后得到了极大的改善,但高风险患者不能从目前获批的药物中获益。最重要的预后因素是17号染色体短臂部分缺失,称为17p缺失(del[17p])。

在小量患者群中的研究显示,只有del(17p)与TP53突变相关时这些患者才具有极高风险,即所谓的“双重打击”人群。

为了验证这一发现,Corre等人设计了一项更大规模的研究,对121位55%以上浆细胞中出现del(17p)的患者进行了一致的强化治疗。

有无del(17p)患者的预后

对于这121位患者,研究人员进行了靶向TP53的深度二代测序,并将结果与一个大量的对照人群(2505例del[17p]缺失的患者)进行对比。

结果证实了“双重打击”是预后最差的情况(中位存活期 36个月),但与对照队列相比,仅携带del(17p)的患者的预后也表现较差(中位存活期 52.8 vs 152.2个月)。

综上所述,该研究明确证实了表现为“双重打击”的患者的极差预后,但也发现仅有del(17p)的患者仍具有高风险特征,证实了del(17p)作为预后不良的指标的价值。

原始出处:

Jill Corre, et al. Del17p without TP53 mutation confers poor prognosis in intensively treated newly diagnosed multiple myeloma patients. Blood. October 20, 2020.

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    2021-09-27 jml2009
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    2020-11-04 Nebula-Qin

    骨髓瘤

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