Supplementary Material for: The Prognostic Impact of MYC Gene-Related Abnormalities on Multiple Myeloma Outcome through Fluorescence in situ Hybridization Analysis

Introduction: Chromosomal abnormalities (CAs) have been identified as important factors in determining the biological features and prognostic value of multiple myeloma (MM). MYC gene-related abnormalities (MYC GAs) are one of the CAs, but its unfavorable impact has not been fully investigated in daily clinical practice. Methods: This study retrospectively analyzed the prognostic impact of MYC GAs on 81 patients through fluorescence in situ hybridization analysis in our institute. Results: MYC GAs were associated with poor overall survival (hazard ratio [HR], 3.08; 95% confidence interval [CI], 1.23–7.73; p = 0.017), progression-free survival (PFS) (HR, 2.96; 95% CI, 1.58–5.53; p < 0.001), and time to next treatment (TNT) (HR, 2.11; 95% CI, 1.13–3.93; p = 0.018) in the median follow-up of 34.7 months. Furthermore, MYC GAs with an additional chromosome 8 (MYC-Ch8(+)) were associated with shorter PFS (HR, 3.15; 95% CI, 1.38–7.2; p = 0.0064), whereas MYC GAs without an additional chromosome 8 (MYC-Ch8(−)) were associated with shorter PFS (HR, 3.62; 95% CI, 1.51–8.68; p = 0.004) and shorter TNT (HR, 3.72; 95% CI, 1.41–9.81; p = 0.0078). Conclusion: These findings could help identify high-risk patients with MM. Further prospective studies are needed to confirm the significance of MYC GAs for the MM prognostic effect.

引言：染色体异常（Chromosomal abnormalities, CAs）已被证实为影响多发性骨髓瘤（multiple myeloma, MM）生物学特性与预后价值的关键因素。MYC基因相关异常（MYC gene-related abnormalities, MYC GAs）属于染色体异常的一类，但其不良临床影响在日常临床实践中尚未得到充分研究。方法：本研究通过本中心的荧光原位杂交（fluorescence in situ hybridization）分析，对81例患者的MYC基因相关异常的预后影响进行了回顾性分析。结果：在中位随访34.7个月的随访周期中，MYC基因相关异常与较差的总生存期（风险比[HR] = 3.08；95%置信区间[CI] = 1.23–7.73；p = 0.017）、无进展生存期（progression-free survival, PFS）（HR = 2.96；95%CI = 1.58–5.53；p < 0.001）以及至下次治疗时间（time to next treatment, TNT）（HR = 2.11；95%CI = 1.13–3.93；p = 0.018）显著相关。进一步分析显示，伴随额外8号染色体的MYC基因相关异常（MYC-Ch8(+)）与更短的无进展生存期相关（HR = 3.15；95%CI = 1.38–7.2；p = 0.0064）；而不伴随额外8号染色体的MYC基因相关异常（MYC-Ch8(-)）则与更短的无进展生存期（HR = 3.62；95%CI = 1.51–8.68；p = 0.004）及更短的至下次治疗时间（HR = 3.72；95%CI = 1.41–9.81；p = 0.0078）显著相关。结论：本研究结果有助于甄别多发性骨髓瘤的高危患者，未来仍需开展前瞻性研究以进一步验证MYC基因相关异常在多发性骨髓瘤预后评估中的临床意义。