The impact of bone marrow fibrosis and JAK2 expression on clinical outcomes in patients with newly diagnosed multiple myeloma treated with immunomodulatory agents and/or proteasome inhibitors.
Adult
Aged
Aged, 80 and over
Biopsy
Bone Marrow
/ chemistry
Confidence Intervals
Female
Follow-Up Studies
Humans
Immunohistochemistry
Immunologic Factors
/ therapeutic use
Janus Kinase 1
/ analysis
Janus Kinase 2
/ analysis
Male
Megakaryocytes
/ chemistry
Middle Aged
Multiple Myeloma
/ drug therapy
Primary Myelofibrosis
/ complications
Prognosis
Progression-Free Survival
Proteasome Inhibitors
/ therapeutic use
Retrospective Studies
Syndecan-1
/ analysis
Treatment Outcome
JAK2
bone marrow fibrosis
immunohistochemical staining
multiple myeloma
overall survival
progression free survival
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
11
02
2020
revised:
09
06
2020
accepted:
10
06
2020
pubmed:
7
7
2020
medline:
5
6
2021
entrez:
7
7
2020
Statut:
ppublish
Résumé
We determined the impact of bone marrow fibrosis (BMF) on the clinical outcomes of newly diagnosed multiple myeloma (NDMM) patients in the current era of myeloma therapy. A total of 393 MM patients were included in the final analysis. The median followup was 83 months (range: 3.9 to 212 months). BMF was noted in 122 (48.2%) evaluable patients. Median progression free survival (PFS) in patients without BMF was 30.2 (95% CI: 24.7-38.0) months, and 21.1 (95% CI: 18.8-27.5) months in patients with BMF present (P = .024). Median overall survival (OS) was 61.2 (95% CI: 51.5-81.2) months in patients without BMF, and 45.1 (95% CI: 38.7-57.0) months in patients with BMF (P = .0048). A subset of 99 patients had their bone marrow biopsies stained for JAK1 and JAK2 by immunohistochemistry. Of these samples 67 (67.7%) patients had detectable JAK2 expression predominantly noted on bone marrow megakaryocytes. JAK2 expression correlated with myeloma disease stage (P = .0071). Our study represents the largest dataset to date examining the association of BMF with prognosis in the era of novel therapies and widespread use of hematopoietic stem cell transplant (HSCT). Our data suggest that MM patients with BMF (particularly those with extensive BMF) have a poorer prognosis even when treated with immunomodulatory agents and proteasome inhibitors.
Identifiants
pubmed: 32628819
doi: 10.1002/cam4.3265
pmc: PMC7433821
doi:
Substances chimiques
Immunologic Factors
0
Proteasome Inhibitors
0
SDC1 protein, human
0
Syndecan-1
0
JAK1 protein, human
EC 2.7.10.2
JAK2 protein, human
EC 2.7.10.2
Janus Kinase 1
EC 2.7.10.2
Janus Kinase 2
EC 2.7.10.2
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
5869-5880Subventions
Organisme : NCI NIH HHS
ID : R01CA197792
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA197792
Pays : United States
Organisme : NCI NIH HHS
ID : R21CA234701
Pays : United States
Organisme : NCI NIH HHS
ID : R21 CA234701
Pays : United States
Organisme : NCI NIH HHS
ID : R44CA199767
Pays : United States
Informations de copyright
© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
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