Complex karyotype and translocation t(4;14) define patients with high-risk newly diagnosed multiple myeloma: results of CMG2002 trial
Language English Country United States Media print-electronic
Document type Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't
- MeSH
- Transplantation, Autologous MeSH
- Chromosome Aberrations MeSH
- Cytogenetic Analysis MeSH
- Adult MeSH
- Incidence MeSH
- Karyotyping * MeSH
- Middle Aged MeSH
- Humans MeSH
- Chromosomes, Human, Pair 14 * MeSH
- Chromosomes, Human, Pair 4 * MeSH
- Survival Rate MeSH
- Multiple Myeloma diagnosis genetics mortality therapy MeSH
- Prognosis MeSH
- Aged MeSH
- Translocation, Genetic * MeSH
- Hematopoietic Stem Cell Transplantation MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Research Support, Non-U.S. Gov't MeSH
The prognostic impact of chromosomal abnormalities was evaluated by fluorescence in situ hybridization with cytoplasmic immunoglobulin light chain staining (cIg-FISH) and by classical metaphase cytogenetics in a cohort of 207 patients with newly diagnosed multiple myeloma who were treated with high-dose therapy followed by autologous stem cell transplantation in the CMG2002 clinical trial. The incidence of chromosomal abnormalities detected by FISH was as follows: 52.7% for del(13)(q14), 6.5% for del(17)(p13), 18.6% for t(11;14)(q13;q32), 22.8% for t(4;14)(p16;q32) and 45.7% for gain(1)(q21). Metaphase cytogenetic analysis revealed a complex karyotype in 19.1% and hyperdiploidy in 21.7% of patients. The overall response rate was not influenced by the presence of any studied chromosomal abnormality. Patients with a complex karyotype, those with translocation t(4;14) and those with gain of the 1q21 locus had a shorter time to progression (TTP) and overall survival (OS). Other genomic changes such as translocation t(11;14) and del(13q) had less impact on TTP and OS. In multivariate analysis, complex karyotype, translocation t(4;14) and β(2)-microglobulin level > 2.5 mg/L were independent prognostic factors associated with poor overall survival. Their unfavorable prognostic impact was even more pronounced if they were present in combination. Patients with t(4;14) present together with a complex karyotype had the worst prognosis, with a median OS of only 13.2 months, whereas patients with a normal karyotype or karyotype with ≤ 2 chromosomal changes had the best outcome, with 3-year OS of 85.9%. In conclusion, complex karyotype, gain of 1q21 region and translocation t(4;14) are major prognostic factors associated with reduced survival of patients with newly diagnosed multiple myeloma treated with autologous stem cell transplantation.
References provided by Crossref.org
Circulating exosomal long noncoding RNA PRINS-First findings in monoclonal gammopathies
Centrosome associated genes pattern for risk sub-stratification in multiple myeloma
Circulating Serum MicroRNA-130a as a Novel Putative Marker of Extramedullary Myeloma
