T(4; 14) Is Not a Poor Prognostic Factor for Newly Diagnosed Multiple Myeloma Patients Undergoing Autologous Stem Cell Transplantation in New Drug Era

Background

The prognostic value of t(4;14) in newly diagnosed multiple myeloma (MM) patients undergoing autologous stem cell transplantation (ASCT) remains controversial. We aimed to evaluate the prognostic value of t(4; 14) for newly diagnosed MM patients undergoing ASCT in new drug era.

Methods

We retrospectively analyzed 419 newly diagnosed MM patients under 66 years of age in Beijing Chaoyang hospital, Capital Medical University. The propensity score matching technique was used to reduce the bias between groups.

Results

Among 419 patients, 243 (58.0%) patients received ASCT after induction therapy including new drugs with 12 months. Patients with ASCT had significantly longer median overall survival (OS) (69.8 vs. 59.3 months, p=0.034) and progression-free survival (PFS) (35.0 vs. 23.9 months, p=0.001) than non-ASCT patients. Univariate Cox proportional hazards regression analyses showed that ASCT was correlated with longer OS (HR=0.720, 95%CI: 0.531-0.977, p=0.035) and PFS (HR=0.618, 95%CI: 0.470-0.814, p=0.001). The favorable effect of ASCT on PFS was confirmed in multivariate (HR=0.376, 95%CI: 0.195-0.723, p=0.003), but it had no impact on OS in multivariate analysis (p=0.289). In the propensity score matching analysis, 116 patients, 58 in each group, were identified. Among 116 matched patients, patients with ASCT had longer PFS (52.1 vs.23.3 months, p=0.002) and OS (89.2 vs.50.2 months, p=0.010). Among 121 patients received ASCT and t(4; 14) measurement by fluorescence in situ hybridization, 30 (24.8%) patients presented translocation t(4; 14). Univariate Cox analyses showed that t(4; 14) was not correlated with PFS (p=0.347) and OS (p=0.454). Multivariate Cox analyses also showed that t(4; 14) was not correlated with PFS (p=0.466) and OS (p=0.349). There was no significant difference in PFS (36.5 vs.37.0 months, p=0.344) or OS (54.0 vs.81.7 months, p=0.452) in ASCT patients with or without t(4;14).

Conclusion

These results demonstrated that ASCT was a favorable prognostic factor for newly diagnosed MM patients under 66 years of age, however, t(4; 14) had no prognostic value for newly diagnosed MM patients received ASCT in new drug era.