NFKB1 −94ins/delATTG polymorphism is a novel prognostic marker in first line‐treated multiple myeloma

Summary Nuclear factor kappa B (NFKB) plays an important role in multiple myeloma (MM), and bortezomib affects this pathway. We retrospectively analysed the effect of the NFKB1 −94ins/delATTG polymorphism on the survival of 295 MM patients treated at a single centre. The median progression‐free survival (PFS) was 790 (659–921) d in patients with NFKB1 homozygous insertion genotype (I/I, n = 99) and 624 (515–733) d in deletion‐carriers (I/D&D/D, n = 196, P = 0·013). In multivariate analysis, I/I carriers showed a favourable PFS compared to I/D&D/D with a hazard ratio of 0·622 (0·457–0·847), P = 0·003, in addition to international staging system (ISS) score, fluorescence in situ hybridization (FISH) risk score, age and bortezomib treatment. I/I patients benefited more from bortezomib treatment [PFS 902 (703–1101) and 580 (343–817), P = 0·008] than I/D&D/D patients [PFS 659 (487–831) and 488 (323–653), P = 0·531]; in addition the beneficial effect of low ISS score was not observed in the I/D&D/D group [PFS 639 (454–824) and 650 (458–842), P = 0·226], while it was clear in I/I patients [PFS 1140 (803–1477) and 580 (408–752), P