Survival analysis of transplant-eligible newly-diagnosed multiple myeloma patients harboring t(4;14), t(14;16), and/or del(17p) in the real-world setting

• Published in: Current problems in cancer Vol. 47; no. 1; p. 100916
• Main Authors: Garrido, David, Slavutsky, Irma, Riva, Eloisa, Peña, Camila, Schutz, Natalia, Tarín-Arzaga, Luz, Martínez-Cordero, Humberto, Bove, Virginia, Osorio, Rocío, Chandía, Mauricio, Beltrán, Cecilia, Schulz, Javier, Cardemil, Daniela, Contreras, Carolina, Vergara, Carmen Gloria, Donoso, Javiera, Espinoza, Marcela, La Rocca, Gabriel, López-Vidal, Hernán, León, Pilar, Hopkins, Christine Rojas, Soto, Pablo, Aranda, Sandra, Torres, Vivianne, Roa, Macarena, Ochoa, Paola, Duarte, Patricio Jose, Remaggi, Guillermina, Yantorno, Sebastián, Corzo, Ariel, Zabaljauregui, Soledad, Shanley, Claudia, Lopresti, Sergio, Orlando, Sergio, Verri, Verónica, Quiroga, Luis, García, Carlos, Fernández, Vanesa, Ramirez, Jhoanna, Verduga, Azucena, Molina, Alicia, Pacheco, María, Mantilla, William, Mite, Alex, Reyes, Inés, Sabando, Brenner, Ramírez, Francisca, Sossa, Claudia, Abello, Virginia, Idrobo, Henry, Cardenas, Kenny Mauricio Galvez, Saavedra, Domingo, Quintero, Guillermo, Gazitúa, Raimundo, Gaviria, Lina, Gomez, Rigoberto, Osuna, Mónica, Henao-Uribe, Alicia, Cantú-Martínez, Omar, Gómez-Almaguer, David, García-Navarrete, Yarely Itzayana, Cruz-Mora, Antonio, Cantero-Fortiz, Yahveth, Ruiz-Argüelles, Guillermo J, Fantl, Dorotea
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2023
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chromosome Aberrations; Female; Hematopoietic Stem Cell Transplantation; Humans; Male; Middle Aged; Multiple myeloma; Multiple Myeloma - diagnosis; Multiple Myeloma - genetics; Multiple Myeloma - therapy; Prognosis; Retrospective Studies; Survival; Survival Analysis; Transplantation, Autologous; Survival; Chromosome aberrations; Hematopoietic stem cell transplantation; Multiple myeloma
• ISSN: 0147-0272; 1535-6345
• DOI: 10.1016/j.currproblcancer.2022.100916

Cytogenetic abnormalities (CA) such as t(4;14), t(14;16), and del(17p), are associated with a poor prognosis in Multiple Myeloma (MM) patients. However, there is scarce information regarding the Latin-American population. This study aims to analyze the impact of t(4;14), t(14;16), and del(17p) on the progression-free survival (PFS) and overall survival (OS) of transplant-eligible newly-diagnosed MM (NDMM) patients in Latin America. Retrospective survival analysis based on the Grupo de Estudio Latinoamericano de MM (GELAMM) registry, including all adult patients with NDMM harboring CA t(4;14), t(14;16), and/or del(17p). Fifty-nine patients were included; the median age was 57 years, 55.9% males, 22% ISS-I, 25.4% ISS-II, and 47.5% ISS-III. The majority (89.8%) had one alteration, whereas 10.2% had del(17p) and t(4;14). The frequencies of CA were del(17p) in 61.0%, t(4;14) in 25.4%, and t(14;16) in 3,4%. Autologous stem cell transplantation was performed in 36 cases, 20 patients did not use this consolidative strategy, and this data was missed in three cases.
Five-year OS for the entire cohort was 60.8% and 5-year PFS was 28.1%. Bortezomib-based induction regimen (BBR) (p=0.029), consolidation with ASCT (p<0.001), and maintenance therapy (p=0.004) were associated with an improved 5-year OS. In the multivariate analysis, ASCT was the only variable with a positive impact on OS (HR 0.11, 95% CI 0.033 to 0.34, p<0.001). The median PFS presented a non-statistically significant benefit in BBR, ASCT, and maintenance therapy groups. BBR induction, ASCT, and maintenance therapy were associated with improved OS in high-risk NDMM patients.