Real-world Outcomes in Newly Diagnosed Multiple Myeloma Based on Interphase Fluorescent In situ Hybridization: A Retrospective Analysis

Punit Jain, Poonam Jain, Agnivesh Tikoo, Tejinder Singh, Salil Patkar, Vaishali Lokhande, Anand Mishra, Bharat Agarwal, Ashwathy Haridas, Kanika Khandelwal
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Abstract

Limited data exist on interphase fluorescent in situ hybridization (iFISH)-based survival outcomes in newly diagnosed multiple myeloma (NDMM) from India. To study the demographics and iFISH-based survival outcomes in NDMM patients treated with proteasome inhibitors from a community-based cancer setup. We reviewed the records of 25 patients treated with proteasome inhibitors between June 2017 and April 2023 using five high-risk (HR) iFISH markers based on mSMART 3.0. The median age was 60 years (range 34–87). HR iFISH was detected in 12 (48%) patients. With a median follow-up of 27 months, the overall response at the last follow-up was 80% (very good partial response - 52%, complete remission - 20%, and partial response - 8%), with 8 (32%) relapses. Twenty (80%) patients remain alive, with five deaths in HR (sepsis [ n = 3]). The 2.5-year overall survival in HR and standard risk was 55.6% ± 15.2% and 100% ( P = 0.01), and event-free survival was 32.4% ± 16.5% and 77.8% ± 13.8% ( P = 0.02), respectively. Using limited iFISH HR markers helps in the early and effective stratification of NDMM in the real world. Sepsis remains an important cause of mortality in an Indian setup.
基于间期荧光原位杂交的新诊断多发性骨髓瘤的真实世界结果:回顾性分析
印度新诊断的多发性骨髓瘤(NDMM)患者基于间期荧光原位杂交(iFISH)的生存结果数据有限。研究社区癌症机构中接受蛋白酶体抑制剂治疗的 NDMM 患者的人口统计学特征和基于 iFISH 的生存结果。我们回顾了2017年6月至2023年4月期间使用蛋白酶体抑制剂治疗的25名患者的记录,这些患者使用了基于mSMART 3.0的五种高风险(HR)iFISH标记物。中位年龄为60岁(34-87岁不等)。12名(48%)患者检测出HR iFISH。中位随访时间为 27 个月,最后一次随访的总体反应率为 80%(非常好的部分反应率为 52%,完全缓解率为 20%,部分反应率为 8%),复发 8 例(32%)。20名(80%)患者仍然存活,其中5人死于HR(败血症[n = 3])。HR和标准风险患者的2.5年总生存率分别为55.6%±15.2%和100%(P = 0.01),无事件生存率分别为32.4%±16.5%和77.8%±13.8%(P = 0.02)。在现实世界中,使用有限的 iFISH HR 标记有助于对 NDMM 进行早期、有效的分层。在印度,败血症仍然是导致死亡的重要原因。
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13 weeks
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