The Effect of Chromosome 1q21 Abnormalities on Outcomes of Autologous Stem Cell Transplantation (ASCT) in Multiple Myeloma Patients

• Published in: Transplantation and cellular therapy Vol. 30; no. 2; p. S394
• Main Authors: Moreb, Jan S., Lantos, Lori, Edwards, Amanda, Chen, Franklin, Dugan, James, Skarbnik, Alan P, Elliott, Kathleen, Kropf, Patricia Lamont, Chilkulwar, Abhishek R, Ward, Kimberly, Thertulien, Raymond
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.02.2024
• ISSN: 2666-6367; 2666-6367
• DOI: 10.1016/j.jtct.2023.12.553

Cytogenetic abnormalities (CA) detected by FISH in multiple myeloma (MM) cells could be highly prognostic of outcome and are incorporated into the Revised International Staging System (R-ISS). Additional copies of chromosome 1q (+1q) is identified in about 40% of newly diagnosed MM (NDMM) patients. Several studies suggested the presence of +1q abnormality negatively affects outcomes in NDMM patients. However, data are conflicting regarding the impact of +1q on ASCT outcomes in these patients. We conducted a retrospective review in our transplant MM patients who had at least 1 year follow up after ASCT. We identified 105 patients during the period Aug 2018 to Sept 2022. We separated patients into 4 groups according to CA including standard risk patients (n=65), any patients with del p53 (n=12), patients with +1q without p53 deletion (n=21), and other high risk patients group that has any or all of the following: t(4;14), t(14;16), t(14;20) (n=7). Patients with high risk CA were put on doublet maintenance usually including an IMiD and a proteasome inhibitor or anti CD38 antibody, otherwise Lenalidomide maintenance for other patients. As expected, patients with del p53 had the highest rate of relapse (RR) (58%) while the other groups had lower rates 12.5-25%. On the other hand, relapse related mortality (RRM) rates were 27% and 12.5% in the del p53 and other high risk group, respectively, while it was 5% in the standard risk group and the +1q group. Further multi variate analysis to include disease stage, absolute lymphocyte count on day +15 and disease status at transplant will be provided. The main conclusion from this study is that, in the current standard of care, MM patients with +1q abnormality, without the presence of del p53, who undergo ASCT, has a RR and RRM similar to that in patients with standard risk MM. Furthermore, patients with del p53 have the highest RR and RRM.