[Molecular genetic methods for the prognostic criteria in multiple myeloma].
Routine cytogenetic and molecular genetic analysis of plasma cell malignancies, such as multiple myeloma, became widespread only recently. As the result of these investigations, it became clear that tumor cell karyotype is fundamental from the viewpoint of therapy selection and prognosis. It is worthwhile to distinguish hyperdiploid and nonhyperdiploid myeloma, while five separate prognostic groups (TCI-5) may be identified on the basis of immunoglobulin gene translocations and cyclin expression. Deletion of the q arm of chromosome 13 or amplification of region 1q21 (and the CKS1B gene) can identify further subgroups of poor prognosis and few therapeutic options. Meanwhile, tumors harboring translocation t(11;14) respond favorably to conventional chemotherapy and exhibit exceptionally good and long-lasting response to high-dose chemotherapy. Progression of the disease may coincide with complex translocations of the c-myc gene or deletions involving the p53 tumor-suppressor gene, spreading of ras-mutations. These events represent clonal evolution at great tumor cell mass and advanced disease, therefore, are only of secondary prognostic significance.
Mikala
Gábor
G
Hematológiai és Haemostasis Osztály.
Jákó
János
J
Vályi-Nagy
István
I
D042846:CDC2-CDC28 Kinases; D002352:Carrier Proteins / Q000235:genetics; D018797:Cell Cycle Proteins / Q000235:genetics; D002869:Chromosome Aberrations; D002882:Chromosomes, Human, Pair 13; D018844:Cyclin-Dependent Kinases; D016213:Cyclins / Q000378:metabolism; D017353:Gene Deletion; D015972:Gene Expression Regulation, Neoplastic; D016259:Genes, myc; D016158:Genes, p53; D011905:Genes, ras; D006801:Humans; D007136:Immunoglobulins / Q000235:genetics; D017404:In Situ Hybridization, Fluorescence; D007621:Karyotyping; D008967:Molecular Biology; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000235:genetics* / Q000628:therapy; D009154:Mutation; D011003:Ploidies; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011379:Prognosis; D011494:Protein Kinases / Q000235:genetics; D014178:Translocation, Genetic
C093090:CKS1B protein, human; D002352:Carrier Proteins; D018797:Cell Cycle Proteins; D016213:Cyclins; D007136:Immunoglobulins; D011494:Protein Kinases; D042846:CDC2-CDC28 Kinases; D018844:Cyclin-Dependent Kinases