Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Mar 1;119(9):2100-5.
doi: 10.1182/blood-2011-11-390658. Epub 2012 Jan 10.

Trisomies in multiple myeloma: impact on survival in patients with high-risk cytogenetics

Shaji Kumar  1 , Rafael Fonseca, Rhett P Ketterling, Angela Dispenzieri, Martha Q Lacy, Morie A Gertz, Suzanne R Hayman, Francis K Buadi, David Dingli, Ryan A Knudson, Alexandra Greenberg, Stephen J Russell, Steven R Zeldenrust, John A Lust, Robert A Kyle, Leif Bergsagel, S Vincent Rajkumar
Affiliations

Trisomies in multiple myeloma: impact on survival in patients with high-risk cytogenetics

Shaji Kumar et al. Blood. .

Erratum in

  • Blood. 2014 Mar 6;123(10):1621

Abstract

Routine incorporation of FISH into multiple myeloma (MM) diagnostic testing has led to a better appreciation of the heterogeneity of genetic abnormalities associated with this disease. We studied a group of 484 patients with newly diagnosed symptomatic MM to better understand the prevalence of the various abnormalities and the prognostic significance of the overlapping abnormalities. A translocation involving the IgH locus and 1 of the 5 recurrent partner chromosomes was seen in 161 (33%) patients, and 275 (57%) had trisomy of at least 1 odd-numbered chromosome. High-risk FISH, defined as the presence of t(4;14), t(14;16), t(14;20), or loss of P53, was seen in 115 (24%) patients; the median overall survival for this group was 3.9 years, compared with "not reached" for standard-risk patients (P < .001). Among the patients with high-risk FISH, 49 patients who also had at least 1 trisomy had a median overall survival that was not reached, compared with 3 years for high-risk patients without a concurrent trisomy (P = .01). Based on the current findings, we conclude that the presence of trisomies in patients with t(4;14), t(14;16), t(14;20), or p53 deletion abnormalities in MM ameliorates the usual adverse impact associated with these prognostic markers.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of various genetic abnormalities among patients with MM. (A) Venn diagram demonstrating the overlapping nature between the common abnormalities seen with FISH in patients with newly diagnosed MM. The actual number of patients with different abnormalities is presented from among 484 patients. The remaining 19 patients either had a normal FISH (n = 15) or another abnormality (n = 4). (B) Distribution of various monosomies/deletions and their overlap.
Figure 2
Figure 2
Kaplan-Meier curves demonstrating OS from diagnosis based on various risk factors. (A) Comparison of OS between patients with standard-risk MM (n = 370) based on FISH testing with those with high-risk MM (n = 114). (B) Comparison of OS between those with standard-risk MM (n = 370), high-risk MM with any trisomy (n = 48), and high-risk MM without any concurrent trisomy (n = 66). (C) Comparison of OS among patients with any trisomy (n = 275) with or without high-risk FISH features.
Figure 3
Figure 3
Kaplan-Meier curves demonstrating OS from diagnosis based on the presence or absence of high-risk IgH translocations or P53 loss. (A-B) Survival of patients with high-risk IgH translocations in the absence (A) or presence (B) of trisomies. (C-D) OS of patients with P53 loss in the absence (A) or presence (B) of trisomies.
Figure 4
Figure 4
Survival of patients according to the revised classification. Previous standard plus high-risk with trisomies (new FISH standard-risk) versus high-risk with no trisomies (new FISH high-risk)
See this image and copyright information in PMC

References

    1. Fonseca R, Barlogie B, Bataille R, et al. Genetics and cytogenetics of multiple myeloma: a workshop report. Cancer Res. 2004;64(4):1546–1558. - PubMed
    1. Fonseca R, Bergsagel PL, Drach J, et al. International Myeloma Working Group molecular classification of multiple myeloma: spotlight review. Leukemia. 2009;23(12):2210–2221. - PMC - PubMed
    1. Avet-Loiseau H, Attal M, Moreau P, et al. Genetic abnormalities and survival in multiple myeloma: the experience of the Intergroupe Francophone du Myelome. Blood. 2007;109(8):3489–3495. - PubMed
    1. Pérez-Simón JA, Garcia-Sanz R, Tabernero MD, et al. Prognostic value of numerical chromosome aberrations in multiple myeloma: A FISH analysis of 15 different chromosomes. Blood. 1998;91(9):3366–3371. - PubMed
    1. Greipp PR, Lust JA, O'Fallon WM, Katzmann JA, Witzig TE, Kyle RA. Plasma cell labeling index and beta 2-microglobulin predict survival independent of thymidine kinase and C-reactive protein in multiple myeloma. Blood. 1993;81(12):3382–3387. - PubMed

Publication types