Gain of 1q22 at diagnosis portends poorer outcomes in multiple myeloma (MM), but the prognostic significance of acquired 1q22 gain is unknown. We identified 63 MM patients seen at Mayo Clinic from 1/2004 to 12/2019 without 1q22 gain at diagnosis who acquired it during follow up and compared them to 63 control patients who did not acquire 1q22 gain with similar follow up. We also compared outcomes in the acquired 1q22 gain group with outcomes in 126 patients with 1q22 gain present at diagnosis. The incidence of acquired 1q22 gain was 6.1% (median follow-up 6.8 years); median time to acquisition was 5.0 years (range: 0.7–11.5 years). Abnormalities on baseline fluorescence in situ hybridization (FISH) included trisomies (54%) and monosomy 13 (39%); 16 (25%) had high-risk (HR) translocations or del(17p). Median progression-free survival with front line therapy was 29.5 months in patients with acquired 1q22 gain, versus 31.4 months in control patients (p = .34) and 31.2 months in patients with de novo 1q22 gain (p = .04). Median overall survival (OS) from diagnosis was 10.9 years in patients with acquired 1q22 gain, versus 13.0 years in control patients (p = .03) and 6.3 years in patients with de novo 1q22 gain (p = .01). Presence of HR FISH at baseline increased risk of 1q22 gain acquisition. We demonstrate that acquisition of 1q22 gain is a significant molecular event in MM, associated with reduced OS. Among HR patients for whom this clonal evolution is determined, a risk-adapted approach and/or clinical trial should be considered.

中文翻译：

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多发性骨髓瘤获得性 1q22 增益的预后意义

诊断时 1q22 增加预示着多发性骨髓瘤 (MM) 的预后较差，但获得性 1q22 增加的预后意义尚不清楚。我们确定了 2004 年 1 月至 2019 年 12 月在 Mayo Clinic 就诊的 63 名 MM 患者，这些患者在诊断时没有获得 1q22 增益，他们在随访期间获得了它，并将他们与 63 名没有获得 1q22 增益的对照患者进行了类似的随访。我们还将获得性 1q22 增益组的结果与 126 名诊断时存在 1q22 增益的患者的结果进行了比较。获得性 1q22 增加的发生率为 6.1%（中位随访 6.8 年）；获得的中位时间为 5.0 年（范围：0.7-11.5 年）。基线荧光原位杂交 (FISH) 异常包括三体性 (54%) 和单体 13 (39%)；16 (25%) 人有高风险 (HR) 易位或 del(17p)。p  = .34) 和 31.2 个月在 1q22 从头增加的患者中 ( p  = .04)。获得性 1q22 增加的患者从诊断开始的中位总生存期 (OS) 为 10.9 年，而对照组患者为 13.0 年 ( p  = .03)，而从头开始 1q22 增加的患者为 6.3 年 ( p  = .01)。基线 HR FISH 的存在增加了获得 1q22 增益的风险。我们证明获得 1q22 增益是 MM 中的一个重要分子事件，与 OS 降低有关。在确定了这种克隆进化的 HR 患者中，应考虑采用风险适应方法和/或临床试验。