Advances In Multiple Myeloma With Chromosome 1Q21 Amplification

Multiple myeloma(MM)is a plasma cell malignant tumor.With the clinical application of new therapeutic methods including proteasome inhibitor(PI),immunomodulatory drugs(IMi Ds),targeted drugs and hematopoietic stem cell transplantation(HSCT),the efficacy of MM patients has been significantly improved.However,the prognosis is highly heterogeneous,with survival ranging from months to decades.Risk stratification based on cytogenetic abnormalities is an important factor affecting the efficacy and prognosis of MM.It has been proved that 1q21 amplification is one of the high-risk abnormalities of MM and plays an increasingly prominent role in the prognosis evaluation of MM.Studies have shown that the amplification region of 1q21 contains pathogenic gene(CKS1B)and drug-resistant gene(PSMD4),and the former is associated with disease progression,while the latter is highly correlated with drug resistance.Studies have confirmed that the expression levels of CKS1 B and PSMD4 genes can be increased with the increase of 1q21 copy number,which leads to the enhancement of tumor proliferation and eventually poor prognosis.It is speculated that the poor prognosis caused by 1q21 amplification may be related to the change of 1q copy number.In addition,it was found that patients with 1q21 amplification were often associated with multiple cytogenetic abnormalities,and their PFS and OS were shorter than those with single genetic abnormality,and their prognosis is worse.Currently,allogeneichematopoietic stem cell transplantation(allo-sct)is the only cure for high-risk cytogenetic abnormalities with lq21 amplification,however,due to the high treaty-related mortality(TRM)and recurrence rate,it is not used in the first-line treatment.For this part of patients,it is of great significance to explore how to optimize the use of existing new drugs and new technologies in the treatment.Therefore,this paper reviews the research progress of bortezomib,thalidomide,lenalidomide,and stem cell transplantation in 1q21 amplification MM.