Multiple myelomda kromozomal aberasyonlar: klinik sonuçlar ve bortezomib’ e yanıt

Year 2019, Volume: 44 Issue: 2, 395 - 401, 30.06.2019

Arbil Açıkalın , Emine Kılıç Bağır , Semra Paydaş , Perihan Alsancak , Melek Ergin

https://doi.org/10.17826/cumj.442276

Abstract

Amaç:Multiple myelom heterojen bir hastalık olup, en etkin
tedavinin planlanlanabilmesi için kromozomal aberasyonların prognostic ve
prediktif değerlerinin anlaşılması önemlidir. Bu çalışmada kurumumuzda tanı
almış hastaların kromozomal aberasyonlarının sıklığını ve tedavi seçenekleri
ile arasındaki ilişkiyi araştırmayı amaçladık.

Gereç ve Yöntem:Ocak
2010 ve Aralık 2015 tarihleri arasında kurumumuzda tanı almış multiple myelomlu
hastalarda, interfaz-floresan in situ hibridizasyon yöntemi ile del(17p13), del(13q14), t(11;14), and
t(4;14) kromozomal aberasyonlarının
sıklığını araştırdık. Bu sonuçların, konvansiyonel kemoterapi alan hastalar ile
bortezomib tabanlı kemoterapi alan hastalardaki yanıtlarını karşılaştırdık.

Bulgular:Seksen hastada (%72.7) en az bir adet kromozomal aberasyon saptandı.
En sık saptanan aberasyon del(17p13)
(%48.2) idi. Bunu sırasıyla del(13q14)
(%40.9), t(11;14) (%16.4), ve t(4;14) (%11.8) takip etmekteydi. Klinik
bulgularına ulaşılabilen 67 hastalık grupta, Bortezomib tabanlı kemoterapi alan
36 hastanın tedaviye yanıt oranı (%55.6) konvansiyonel kemoterapi alan gruba
oranla (%48.4) daha yüksek idi. Kromozomal aberasyonlar ile
karşılaştırıldığında; del (17p13) saptanan
hastaların Bortezomib tabanlı kemoterapiye yanıtları (%63.2), konvansiyonel
kemoterapi alanlardan (%50) daha yüksek saptandı. Benzer şonuç; del (13q14) saptanan  hastalarda
da gözlendi (Bortezomib alanlarda %61.5, konvansiyonel kemoterapi alanlarda
%50).

Sonuç: Bortezomib içeren tedaviler özellikle del (17p13) ve del (13q14) aberayonu
saptanan hastalarda daha iyi sonuç vermektedir.

Keywords

bortezomib, kromozomal aberasyon, multiple myeloma

Chromosomal aberrations in multiple myeloma: clinical outcome and response to bortezomib.

Abstract

Purpose: Multiple myeloma is a heterogeneous disease, for which an understanding of the prognostic and predictive value of chromosomal aberrations is necessary to prescribe the most appropriate therapy. We aimed to document the frequencies of chromosomal aberrations in our institute and searched the relationships between therapy regimens and chromosomal aberrations.

Materials and methods: We analyzed the frequency of del(17p13), del(13q14), t(11;14), and t(4;14) in patients with MM by interphase-fluorescent in situ hybridization who were diagnosed between January 2010 and December 2015 in our institute. We researched the relationship between response to conventional chemotherapy and Bortezomib based chemotherapy.

Results: Eighty patients (72.7%) had at least one chromosomal aberration. The most frequently observed aberration was del(17p13) (48.2%), followed by del(13q14) (40.9%), t(11;14) (16.4%), and t(4;14) (11.8%). In clinically analyzed subgroup (n=67), 36 patients who received Bortezomib based chemotherapy showed a higher response rate (55.6%) than conventional chemotherapy group (48.4%). With respect to chromosomal aberrations, response rates were higher in Bortezomib based therapy group (63.2%) than conventional chemotherapy group  (50%) in del (17p13) positive patients as well as in del (13q14) positive patients (61.5% in Bortezomib based, 50% in conventional chemotherapy group).

Conclusion: Bortezomib-containing regimens may have beneficial effects on the clinical outcome of patients with del (17p13) and del (13q14). 

Keywords

bortezomib, chromosomal aberration, multiple myeloma

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