The Role of 1q21 Gain on the Prognosis of Multiple Myeloma

Abstract: Multiple myeloma (MM) is a clonal expansion of malignant plasma cells, and comprises approximately 10% of hematologic malignancies. Although various therapeutic agents and strategies, such as immunomodulatory agents, proteasome inhibitors, monoclonal antibodies and hematopoietic stem cell transplantation (HSCT) have been evaluated, MM remains largely incurable. It is therefore important to further explore the risk factors for disease progression, and to design trials aimed at improving the patient outcomes. Previous studies have considered the presence of a gain in 1q21 as a risk factor for a poorer overall survival. Gain of 1q21 is one of the most common chromosomal aberrations in MM, being detected by fluorescence in situ hybridization in 36% to 47% of newly-diagnosed patients, as well as 52% and 62% patients with relapsed MM. Although a series of reports identified 1q21 gain in MM as a significant and independent poor prognostic factor, other studies failed to demonstrate any prognostic value. Thus, the prognostic value of 1q21 gain in MM remains controversial. We reviewed the current knowledge about 1q21 gain and its value for the clinical management of MM.