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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.
Paul, Barry; Zhao, Yue; Loitsch, Gavin; Feinberg, Daniel; Mathews, Parker; Barak, Ian; Dupuis, Megan; Li, Zhiguo; Rein, Lindsay; Wang, Endi; Kang, Yubin.
Afiliación
  • Paul B; Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA.
  • Zhao Y; Department of Pathology, Duke University Medical Center, Durham, NC, USA.
  • Loitsch G; Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA.
  • Feinberg D; Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA.
  • Mathews P; Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA.
  • Barak I; Biostatistics Shared Resource, Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA.
  • Dupuis M; Hematology/Oncology Fellowship Program, MD Anderson Cancer Center, University of Texas, Houston, TX, USA.
  • Li Z; Biostatistics Shared Resource, Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA.
  • Rein L; Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA.
  • Wang E; Department of Pathology, Duke University Medical Center, Durham, NC, USA.
  • Kang Y; Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA.
Cancer Med ; 9(16): 5869-5880, 2020 08.
Article en En | MEDLINE | ID: mdl-32628819
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Janus Quinasa 2 / Mielofibrosis Primaria / Inhibidores de Proteasoma / Factores Inmunológicos / Mieloma Múltiple Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Cancer Med Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Janus Quinasa 2 / Mielofibrosis Primaria / Inhibidores de Proteasoma / Factores Inmunológicos / Mieloma Múltiple Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Cancer Med Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos