Abnormal cytogenetics predict poor survival after high-dose therapy and autologous blood cell transplantation in multiple myeloma.
We compared the prognostic value of conventional cytogenetic analysis and established factors such as beta2-microglobulin and plasma cell labeling index in 70 patients undergoing autologous blood cell transplantation for multiple myeloma. Patients underwent transplantation 5 to 88 months (median, 20 months) after the initial diagnosis of myeloma. Factors studied were age, sex, beta2-microglobulin, response to prior therapy, plasma cell labeling index, cytogenetic analysis, bone marrow plasma cell percentage, lactate dehydrogenase and C-reactive protein. Twenty-eight of 65 patients (43%) had abnormal marrow cytogenetics. Overall survival measured from transplantation was significantly better in patients with normal cytogenetics than in those with abnormal cytogenetics (median survival, 25 vs 12 months, P = 0.003). Progression-free survival was better, with median times of 12 vs7 months, respectively (P = 0.005); overall survival measured from the time myeloma was first diagnosed was also longer, with median survivals of 62 and 39 months, respectively (P = 0.001). Median plasma cell labeling index was 1.5% in patients with abnormal cytogenetics and 0. 2% in those with normal cytogenetics (P < 0.001). Abnormal bone marrow cytogenetics predict poor survival after blood cell transplantation for myeloma. There is a significant correlation between abnormal cytogenetics and high plasma cell labeling index, suggesting that certain cytogenetic abnormalities may offer a proliferative advantage to myeloma cells.
Rajkumar
S
S
Division of Hematology and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
Fonseca
R
R
Lacy
M
M
Witzig
T
T
Lust
J
J
Greipp
P
P
Therneau
T
T
Kyle
R
R
Litzow
M
M
Gertz
M
M
D000328:Adult; D000368:Aged; D000782:Aneuploidy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D001853:Bone Marrow / Q000473:pathology; D002869:Chromosome Aberrations; D002872:Chromosome Deletion; D002877:Chromosomes, Human / Q000648:ultrastructure; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D009101:Multiple Myeloma / Q000188:drug therapy / Q000235:genetics / Q000401:mortality* / Q000628:therapy; D009363:Neoplasm Proteins / Q000097:blood; D010950:Plasma Cells / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D016019:Survival Analysis; D014178:Translocation, Genetic; D014314:Trisomy; D001613:beta 2-Microglobulin / Q000032:analysis
D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D001613:beta 2-Microglobulin