Analysis of my bone marrow showed chromosome gain in 1q which my specialist said would tend to reduce the length of remissions. However, she was unable to quantify the amount of reduction.
Does anyone have any information on this?
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Richard - Name: Richard
- Who do you know with myeloma?: me
- When were you/they diagnosed?: February 2014
- Age at diagnosis: 65
Re: Impact of 1q gain on length of remission?
Hi Richard,
It looks like you are new to posting on the forum, so welcome.
From your profile, it looks like you are based in the UK, on CTD (cyclophosphamide, dex + thalidomide) and you are considering an auto transplant really soon, right?
Here is an article from the Beacon on the subject of 1q gains and their implications for prognosis. Note that the study included a cohort of patients that used the CTD regimen.
"Gain In chromosome 1 Negatively Affects Prognosis Only In Certain Newly Diagnosed Myeloma Patients," The Myeloma Beacon, April 30, 2012.
If you google on "1q21 prognosis ncbi", you can find a number of studies that compare PFS in both 1q21-gain and non-1q21-gain patients.
Hope this helps.
It looks like you are new to posting on the forum, so welcome.
From your profile, it looks like you are based in the UK, on CTD (cyclophosphamide, dex + thalidomide) and you are considering an auto transplant really soon, right?
Here is an article from the Beacon on the subject of 1q gains and their implications for prognosis. Note that the study included a cohort of patients that used the CTD regimen.
"Gain In chromosome 1 Negatively Affects Prognosis Only In Certain Newly Diagnosed Myeloma Patients," The Myeloma Beacon, April 30, 2012.
If you google on "1q21 prognosis ncbi", you can find a number of studies that compare PFS in both 1q21-gain and non-1q21-gain patients.
Hope this helps.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Impact of 1q gain on length of remission?
Thanks very much for the information, Multibilly. I shall have to ask if I had other chromosomal abnormalities, and also dig further into the literature you have highlighted.
You are right that I had CDT chemo, and responded well to it, followed by autologous stem cell transplant just 3 weeks ago.
You are right that I had CDT chemo, and responded well to it, followed by autologous stem cell transplant just 3 weeks ago.
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Richard - Name: Richard
- Who do you know with myeloma?: me
- When were you/they diagnosed?: February 2014
- Age at diagnosis: 65
Re: Impact of 1q gain on length of remission?
This is a topic that interests me as well because I just met with my myeloma specialist and he said I am considered Stage 1 with intermediate risk due to the +1q chromosomal abnormality.
I have read this may make remission more difficult to achieve. I will be starting treatment with Revlimid, Velcade, and dexamethasone (RVD) soon.
Does anyone have additional information on the impact of this chromosomal abnormality?
I have read this may make remission more difficult to achieve. I will be starting treatment with Revlimid, Velcade, and dexamethasone (RVD) soon.
Does anyone have additional information on the impact of this chromosomal abnormality?
Re: Impact of 1q gain on length of remission?
I’m also interested in info on this topic.
I’ve been on Velcade, Revlimid, and dexamethasone (VRD) treatment since early November. I also have chromosome 1q identified on one of my assessments, as well as t(14:16). I was classed as stage 3.
My oncologist has been focusing on reducing risk factors and moving my lab results into more normal range, with good results. Our only discussion about the chromosomes has been that they might cause diminishing success with treatment down the road. We’ve talked about possibly referring me to a myeloma specialist in another month or so if my labs continue / remain in the normal range. I anticipate more discussion then about possible transplant, remission prognosis, and the potential effect of the chromosomes. Any info here before that may help me understand an area in which I’m less than knowledgeable.
I’ve been on Velcade, Revlimid, and dexamethasone (VRD) treatment since early November. I also have chromosome 1q identified on one of my assessments, as well as t(14:16). I was classed as stage 3.
My oncologist has been focusing on reducing risk factors and moving my lab results into more normal range, with good results. Our only discussion about the chromosomes has been that they might cause diminishing success with treatment down the road. We’ve talked about possibly referring me to a myeloma specialist in another month or so if my labs continue / remain in the normal range. I anticipate more discussion then about possible transplant, remission prognosis, and the potential effect of the chromosomes. Any info here before that may help me understand an area in which I’m less than knowledgeable.
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michaelgreer - Who do you know with myeloma?: Self
- When were you/they diagnosed?: 10/25/17
- Age at diagnosis: 68
Re: Impact of 1q gain on length of remission?
Michaelgreer,
I am glad you are responding well to the treatment.
I am glad you are responding well to the treatment.
Re: Impact of 1q gain on length of remission?
Hi,
I've listed below a recent study with information about the impact of chromosome 1q gain on prognosis in myeloma patients, particularly myeloma patients who include stem cell transplantation as part of their initial therapy. I've also included a link to a commentary that was published about the study.
The authors of the study found that patients with 1q gain had similar responses to induction therapy and stem cell transplantation as patients who did not have 1q gain. However, the time to relapse, as measured by progression-free survival, was noticeably shorter for 1q gain patients, as was overall survival.
As always, individual cases will vary, and the overall survival data in particular need to be taken with a grain of salt, as the study sample probably included patients who were diagnosed 5-10 years ago, well before some of the new therapies that are significantly extending myeloma survival.
Also, it's not clear from the study abstract whether the authors tried to tease out the independent impact of 1q gain. This is important because, as noted in the abstract, other mutations occur in many 1q gain patients. More than a third of the 1q gain patients, for example, have the TP53 mutation, the study finds, and the TP53 mutation itself is associated with more aggressive disease.
Article:
"Gain of chromosome 1q portends worse prognosis in multiple myeloma despite novel agent-based induction regimens and autologous transplantation"
http://www.tandfonline.com/doi/full/10.1080/10428194.2016.1260126?src=recsys
Abstract:
We aimed to identify whether the use of autologous hematopoietic cell transplantation (HCT) impacts outcomes for multiple myeloma patients with gains of chromosome 1q (+1q). We retrospectively identified 95 patients, 21% having +1q. For patients with +1q, the overall response rate to induction was 85%, with 40% having ≥ VGPR and 20% achieving a CR, similar to non +1q patients (p = .64). The median PFS from diagnosis with +1q was 2.1 years (95% CI: 1.2–not reached (NR)) vs 4.3 years (95% CI: 3.3 yrs–NR) without +1q (p = .003). Median OS from diagnosis was 4.4 years (95% CI: 2.9–NR) vs not reached, respectively (p = .005). On molecular analysis using the Foundation One Heme assay, the most common mutations seen in +1q patients included TP53 (38%) and KRAS (25%). Overall, gain of 1q portends worse PFS and OS which was not negated by auto HCT. Such patients will likely require additional therapy to improve their survival.
Commentary on article:
"+1q: amplifying the bad genes in myeloma"
http://www.tandfonline.com/doi/abs/10.1080/10428194.2016.1272689?journalCode=ilal20
I've listed below a recent study with information about the impact of chromosome 1q gain on prognosis in myeloma patients, particularly myeloma patients who include stem cell transplantation as part of their initial therapy. I've also included a link to a commentary that was published about the study.
The authors of the study found that patients with 1q gain had similar responses to induction therapy and stem cell transplantation as patients who did not have 1q gain. However, the time to relapse, as measured by progression-free survival, was noticeably shorter for 1q gain patients, as was overall survival.
As always, individual cases will vary, and the overall survival data in particular need to be taken with a grain of salt, as the study sample probably included patients who were diagnosed 5-10 years ago, well before some of the new therapies that are significantly extending myeloma survival.
Also, it's not clear from the study abstract whether the authors tried to tease out the independent impact of 1q gain. This is important because, as noted in the abstract, other mutations occur in many 1q gain patients. More than a third of the 1q gain patients, for example, have the TP53 mutation, the study finds, and the TP53 mutation itself is associated with more aggressive disease.
Article:
"Gain of chromosome 1q portends worse prognosis in multiple myeloma despite novel agent-based induction regimens and autologous transplantation"
http://www.tandfonline.com/doi/full/10.1080/10428194.2016.1260126?src=recsys
Abstract:
We aimed to identify whether the use of autologous hematopoietic cell transplantation (HCT) impacts outcomes for multiple myeloma patients with gains of chromosome 1q (+1q). We retrospectively identified 95 patients, 21% having +1q. For patients with +1q, the overall response rate to induction was 85%, with 40% having ≥ VGPR and 20% achieving a CR, similar to non +1q patients (p = .64). The median PFS from diagnosis with +1q was 2.1 years (95% CI: 1.2–not reached (NR)) vs 4.3 years (95% CI: 3.3 yrs–NR) without +1q (p = .003). Median OS from diagnosis was 4.4 years (95% CI: 2.9–NR) vs not reached, respectively (p = .005). On molecular analysis using the Foundation One Heme assay, the most common mutations seen in +1q patients included TP53 (38%) and KRAS (25%). Overall, gain of 1q portends worse PFS and OS which was not negated by auto HCT. Such patients will likely require additional therapy to improve their survival.
Commentary on article:
"+1q: amplifying the bad genes in myeloma"
http://www.tandfonline.com/doi/abs/10.1080/10428194.2016.1272689?journalCode=ilal20
Re: Impact of 1q gain on length of remission?
Hi,
I am interested in this as I too have 1q deletion and am very firmly defined as refractory. I have only in the last few months achieved something approaching remission thanks to Darzalex (daratumumab). Up until now I have been on Revlimid (lenalidomide), cyclophosphamide, Velcade, dexamethasone and prednisolone in various combinations.
After 3 years on and off, mostly on, treatment, my paraprotein, IgG kappa, was at 43 and light chains 1400 and a ratio of over a thousand. My haematologist applied and got Darzalex through the NHS, which I take with dex and Revlimid. On Christmas Eve my haematologist rang me to say my proteins are down to 11 and light chains to 60 after 2 cycles. Hopefully this continues and they will try to harvest stem cells soon and 2018 is more positive than 2017.
I am interested in this as I too have 1q deletion and am very firmly defined as refractory. I have only in the last few months achieved something approaching remission thanks to Darzalex (daratumumab). Up until now I have been on Revlimid (lenalidomide), cyclophosphamide, Velcade, dexamethasone and prednisolone in various combinations.
After 3 years on and off, mostly on, treatment, my paraprotein, IgG kappa, was at 43 and light chains 1400 and a ratio of over a thousand. My haematologist applied and got Darzalex through the NHS, which I take with dex and Revlimid. On Christmas Eve my haematologist rang me to say my proteins are down to 11 and light chains to 60 after 2 cycles. Hopefully this continues and they will try to harvest stem cells soon and 2018 is more positive than 2017.
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JellytotJane
Re: Impact of 1q gain on length of remission?
Congratulations, JellytotJane, on the great response to your treatment regimen. That's indeed a good Christmas and new year present.
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Jose - Name: Marlo
- Who do you know with myeloma?: myself
- Age at diagnosis: 42
9 posts
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