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目的探讨1q21扩增在多发性骨髓瘤(MM)危险分层治疗中的意义。方法采用荧光原位杂交技术检测60例MM患者的1q21位点,分析1q21扩增与MM临床病理特征的相关性及其对不同危险分层中新药治疗和传统化疗疗效的影响。结果 1q21扩增阳性与MM患者的国际分期系统分期、危险分层以及血红蛋白、白蛋白和β_2微球蛋白水平有关(P<0.05)。采用新药治疗患者的总有效率高于传统化疗患者(90.0% vs.63.3%)(P<0.05)。低危患者采用新药治疗和传统化疗后的总有效率比较差异无统计学意义(P>0.05);高危伴1q21扩增阳性患者采用新药治疗的总有效率高于传统化疗(P<0.05),而高危伴1q21扩增阴性患者采用传统化疗与新药治疗的总有效率比较差异无统计学意义(P>0.05)。结论 MM高危患者采用新药治疗可提高1q21扩增的缓解率,克服1q21扩增对不良预后的影响;而低危患者采用新药治疗相较于传统化疗无明显优势,且1q21扩增与否对治疗效果无影响。
Objective To investigate the significance of 1q21 amplification in risk stratification of multiple myeloma (MM). Methods Fluorescence in situ hybridization was used to detect the 1q21 locus in 60 patients with MM. The correlation between 1q21 amplification and the clinicopathological features of MM and the effect of 1q21 amplification on the efficacy of new drug and traditional chemotherapy in different risk stratification were analyzed. Results The positive results of 1q21 amplification were related to the international staging system, risk stratification and the levels of hemoglobin, albumin and β_2 microglobulin in MM patients (P <0.05). The total effective rate of the new drug treatment patients was higher than that of the traditional chemotherapy patients (90.0% vs.63.3%) (P <0.05). There was no significant difference in the total effective rate between the low-risk patients treated with the new drug and the traditional chemotherapy (P> 0.05). The total effective rate of the new drug in the high-risk patients with 1q21 amplification was higher than that of the traditional chemotherapy (P <0.05) However, there was no significant difference between the two groups (P> 0.05). However, there was no significant difference between the two groups (P> 0.05). Conclusion The treatment of high-risk MM patients with new drugs can improve the response rate of 1q21 amplification and overcome the impact of 1q21 amplification on adverse prognosis. However, the treatment of low-risk patients with new drugs has no obvious advantage compared with traditional chemotherapy, and 1q21 amplification or not No effect.