Proteasome inhibitors and IMiDs can overcome some high-risk cytogenetics in XXXX but not gain 1q21.

@entity1 @entity1582 @entity2008 @entity1054 @entity1349
UNASSIGNED: Chromosomal aberrations have significant prognostic importance in @entity1582 ( @entity1582 ). However, proteasome inhibitors (PI) and IMiDs may partly overcome the poor prognostic impact of some of them. In this study, we investigated a population-based consecutive cohort newly diagnosed @entity1 with @entity1582 admitted during a defined time period to hospitals in Denmark, Norway, and Sweden. The impact of treatment modality on the prognostic importance of specific chromosomal aberration was investigated, with special reference to gain 1q21. The median follow-up of @entity1 still alive at analysis was 40  months for the high-dose (HDT)-treated ones and 29  months for the whole population. Three hundred forty-seven @entity1 with a known 1q21 status were included in this study. The 347 @entity1 were divided into three groups, that is, 119 @entity1 with the 1q21 gain, 105 @entity1 with @entity2008 ( @entity2008 ), that is, del(13q), del(17p), t(4,14), and/or (14;16), and 123 @entity1 with no aberrations (NA). The groups were compared in terms of @entity1349 ( @entity1349 ), @entity1054 ( @entity1054 ), and response. The 3-yr @entity1349 for @entity1 with gain 1q21 was 60% compared to @entity1 with @entity2008 74% and NO 82% (gain 1q21 vs. NO P  <  0.001; gain 1q21 vs. @entity2008 P  =  0.095). If treated with PI or IMiDs, the 3-yr @entity1349 was 58% for @entity1 with gain 1q21 compared to @entity1 with @entity2008 78% and NO 78%, respectively (P  =  0.041, P  =  0.140). In HDT @entity1 , the 3-yr @entity1349 was 69% for @entity1 with gain 1q21 compared to @entity1 with @entity2008 84% and NO 88%, respectively (P  <  0.008, P  =  0.600). Thus, neither HDT nor using PI or IMiDs could overcome the poor prognostic impact of gain 1q21, while these drugs and HDT seemed to improve @entity1349 in @entity1 with @entity2008 , approaching the survival in NO. Further, gain 1q21 appears to be one of the most important poor prognostic chromosomal aberrations in @entity1582 with current treatments. Trials using new drugs or allogeneic transplantation are warranted.
