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. 2014 Nov 15;7(11):4051-62.
eCollection 2014.

Prognostic value and efficacy evaluation of novel drugs for cytogenetic aberrations in multiple myeloma: a meta-analysis

Wenjun Yu  1 , Jianyong Li  1 , Lijuan Chen  1
Affiliations

Prognostic value and efficacy evaluation of novel drugs for cytogenetic aberrations in multiple myeloma: a meta-analysis

Wenjun Yu et al. Int J Clin Exp Med. .

Abstract

Cytogenetic abnormalities have emerged as the major novel prognostic factors in multiple myeloma (MM) patients. This meta-analysis comprehensively investigates the association between the cytogenetic abnormalities and survival of MM patients. We searched the PubMed, EMBASE, SCOPUS, and Cochrane databases for articles published until February, 2014. Thirty eligible studies involving 10276 patients were included to examine the association of three chromosomal abnormalities, t (4; 14), del (17p), and Amp (1q21), with survival in MM patients. The main outcome measures were progression-free survival (PFS) and overall survival (OS). Individuals with t (4; 14), del (17p), and Amp (1q21) had low OS and PFS. In a subgroup analysis for therapy regimen, lenalidomide- and bortezomib-based therapies increased the PFS of patients with Amp (1q21) (HR=1.50, 95% CI=0.95-2.36, p=0.084) and t (4; 14) (HR=1.38, 95% CI=0.90-2.11, p=0.143). The presence of del (17p) elicited no significant influence on the prognosis of patients under different therapy regimens. Our meta-analysis provides globally quantifiable confirmation of the adverse prognostic value of t (4; 14), del (17p), and Amp (1q21) in OS and PFS for MM patients. Lenalidomide- and bortezomib-based therapies were partly conducive to improve the prognosis of individuals with t (4; 14). Bortezomib-based therapy can partly improve the PFS of patients with Amp (1q21).

Keywords: Cytogenetic aberrations; bortezomib; lenalidomide; meta-analysis; multiple myeloma; prognosis.

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Figures

Figure 1
Figure 1
Flowchart of selection of studies.
Figure 2
Figure 2
Forest plot of the pooled HRs for overall survival. A: del 17p; B: 1q21+; C: t (4; 14).
Figure 3
Figure 3
Forest plot of the pooled HRs for progression-free survival. A: del 17p; B: 1q21+; C: t (4; 14).
Figure 4
Figure 4
Funnel plots of studies for overall survival and progression-free survival. A: del 17p OS; B: 1q21+ OS; C: t (4; 14) OS; D: del 17p PFS; E: 1q21+ PFS; F: t (4; 14) PFS.
See this image and copyright information in PMC

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