Prognostic factors for hyperdiploid-myeloma: effects of chromosome 13 deletions and IgH translocations.
Chromosomal hyperdiploidy is the defining genetic signature in 40-50% of myeloma (MM) patients. We characterize hyperdiploid-MM (H-MM) in terms of its clinical and prognostic features in a cohort of 220 H-MM patients entered into clinical trials. Hyperdiploid-myeloma is associated with male sex, kappa immunoglobulin subtype, symptomatic bone disease and better survival compared to nonhyperdiploid-MM (median overall survival 48 vs 35 months, log-rank P = 0.023), despite similar response to treatment. Among 108 H-MM cases with FISH studies for common genetic abnormalities, survival is negatively affected by the existence of immunoglobulin heavy chain (IgH) translocations, especially those involving unknown partners, while the presence of chromosome 13 deletion by FISH did not significantly affect survival (median overall survival 50 vs 47 months, log-rank P = 0.47). Hyperdiploid-myeloma is therefore a unique genetic subtype of MM associated with improved outcome with distinct clinical features. The existence of IgH translocations but not chromosome 13 deletion by FISH negatively impacts survival and may allow further risk stratification of this population of MM patients.
Chng
W J
WJ
Division of Hematology-Oncology, Mayo Clinic Scottsdale, AZ 85259, USA.
Santana-Dávila
R
R
Van Wier
S A
SA
Ahmann
G J
GJ
Jalal
S M
SM
Bergsagel
P L
PL
Chesi
M
M
Trendle
M C
MC
Jacobus
S
S
Blood
E
E
Oken
M M
MM
Henderson
K
K
Kyle
R A
RA
Gertz
M A
MA
Lacy
M Q
MQ
Dispenzieri
A
A
Greipp
P R
PR
Fonseca
R
R
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002869:Chromosome Aberrations; D002872:Chromosome Deletion; D002882:Chromosomes, Human, Pair 13 / Q000235:genetics*; D002886:Chromosomes, Human, Pair 17 / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D016158:Genes, p53 / Q000235:genetics; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000235:genetics*; D011123:Polyploidy; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015996:Survival Rate; D014178:Translocation, Genetic; D016896:Treatment Outcome
D007143:Immunoglobulin Heavy Chains