[The prognostic value of t(14;16) translocation in newly diagnosed multiple myeloma patients]

Objective: To evaluate the clinical characteristics and prognostic value of t(14;16) translocation in patients with newly diagnosed multiple myeloma (MM). Methods: Clinical data of MM patients newly diagnosed at Beijing Chaoyang Hospital, Capital Medical University from January 1, 2010 to May 1, 2022 were retrospectively analyzed. Clinical characteristics, cytogenetic abnormalities, and follow-up data were collected. The efficacy of induction therapy was evaluated. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Based on cytogenetic data, patients were divided into those with and those without t(14;16). Propensity score matching based on age, International Staging System (ISS) stage, 1q21 gain/amplification, and del(17p13), with a caliper width of 0.2, was used to reduce bias. Cox proportional hazard regression was used to identify prognostic factors. The Kaplan-Meier method was used for survival analysis. Results: A total of 774 patients with newly diagnosed MM were included. The median age of the included patients was 61 (range 33-87) years, with a male-to-female ratio of 1.22∶1. Among the included patients, translocation t(14;16) was observed in 35 (4.5%, 35/774). Twenty-six (74.3%, 26/35) patients with t(14;16) had concomitant 1q21 gain/amplification [six of them also had del (17p)], while only eight patients (22.9%, 8/35) had isolated t(14;16). Multivariable Cox proportional hazards regression analysis showed that t(14;16) was a poor prognostic factor for OS (HR=1.988, 95%CI 1.288-3.068, P=0.002) and PFS (HR=1.622, 95%CI 1.090-2.413, P=0.017) of patients with newly diagnosed MM. After propensity score matching, the overall response rates after treatment in the t(14;16) and non-t(14;16) groups were 90.9% (30/33) and 84.8% (28/33), respectively; there was no statistically significant difference in efficacy between the two groups (P=0.454). Among the matched patients, the median OS and PFS of patients with t(14;16) were 35.1 (95%CI 26.5-43.6) and 21.2 (95%CI 13.1-29.2) months, respectively, and those of patients without t(14;16) were 64.8 (95%CI 42.1-87.4) and 35.4 (95%CI 23.1-47.6) months, respectively; the difference in OS was not statistically significant (P=0.053), whereas the difference in PFS was statistically significant (P=0.038). Conclusion: t(14;16) translocation is frequently accompanied by 1q21 gain/amplification and is a poor prognostic factor for OS and PFS in patients with newly diagnosed MM.