A retrospective analysis finds high-risk fluorescent in situ hybridization markers useful for stratifying real-world survival outcomes in newly diagnosed multiple myeloma patients.
Interphase fluorescent in situ hybridization (iFISH) remains the standard of care for assessing prognosis in patients with newly diagnosed multiple myeloma (NDMM). There is, however, limited data regarding iFISH-based real-world survival outcomes.
In this retrospective analysis, the authors evaluated iFISH-based survival outcomes in NDMM patients receiving proteasome inhibitors. The findings are published in the journal Apollo Medicine.
Baseline Characteristics
The study included 25 adults with NDMM, with a median age of 60 (34–87) years. Of the total patients, five were in stage I of the disease, whereas eight patients were identified in stages II and III of the disease.
High-Risk Interphase Fluorescent In-Situ Hybridization Markers
High-risk iFISH markers were detected in 12 patients, including cyclin-dependent kinases regulatory subunit 1B (CKS1B) in 9 patients, fibroblast growth factor receptor 3 (IGH-FGFR3) in 2 patients, and del17p mutation in 1 patient.
Treatments Utilized
Treatments administered to the NDMM patients included injection bortezomib [V], oral lenalidomide [R], and oral dexamethasone [d] (RVd), in 20 patients; oral cyclophosphamide [Cy], injection bortezomib [Bor], and oral dexamethasone [d] (CyBord), in two patients; carfilzomib [K], oral lenalidomide [R], and oral dexamethasone [d] (KRd), in one patient; and daratumumab [D] + RVd (DRVd) in two patients.
Toxicity to Proteasome Inhibitors
Among patients on the RVd regimen, three developed grade II thrombocytopenia and four developed grade II anemia and neutropenia during cycle 3 of the treatment. This was related to lenalidomide. After four cycles of RVd treatment, one patient developed grade III sensorimotor peripheral neuropathy in both lower limbs, which was associated with bortezomib.
Real-Word Outcomes in Newly Diagnosed Multiple Myeloma Patients
The overall treatment response to the four induction cycles was approximately 92%. The 2.5-year overall survival was 55.6% in high-risk and 100% in standard-risk cohorts (p = 0.01). The 2.5-year event-free survival in high-risk and standard-risk cohorts was 34.2 ± 16.5% and 77.8 ± 13.8%, respectively. Five patients died, with three deaths associated with severe sepsis.
Source:
Jain, P., Jain, P., Tikoo, A., Singh, T. P., Patkar, S., Lokhande, V., Mishra, A., Agarwal, B., Haridas, A., & Khandelwal, K. (2024). Real-world Outcomes in Newly Diagnosed Multiple Myeloma Based on Interphase Fluorescent In situ Hybridization: A Retrospective Analysis. Apollo Medicine. https://doi.org/10.1177/09760016241239849
