Interphase fluorescence in situ hybridization in multiple myeloma and monoclonal gammopathy of undetermined significance without and with positive plasma cell identification: analysis of 192 cases from the Region of Southern Denmark.
Interphase fluorescence in-situ hybridization (i-FISH) was used to investigate 192 patients with multiple myeloma (MM; n = 182) and benign monoclonal gammopathy of undetermined significance (MGUS; n = 10). Of the 182 MM cases, 132 were investigated without and 50 with positive plasma cell identification (PC-ID+); 134 were investigated at diagnosis, 32 at time of progression, 7 at time of relapse, and 9 were investigated with partial remission or no response. The FISH analysis detected 11q23 (n = 61), 13q13 approximately q14 (n = 181), 14q32 (n = 121), 17p13.1 (n = 181), t(4;14) (n = 76), and t(11;14) (n = 73). Of the 132 patients investigated without PC-ID+, 61 (46%) showed chromosomal abnormalities, compared with 45 of 49 of evaluable cases (92%) with PC-ID+. The increase in abnormal cases identified was due mainly to the detection of more cases with 13q-, 17p-, and der(14)(q32). G-banding cytogenetics was performed in 72 patients; abnormalities were revealed in 19 cases (26%). Concordance between G-banding and i-FISH for one or more aberrations was found in 14 patients. Translocation (11;14) was detected by both methods in four of five cases. In four out of seven cases with either near-tetraploidy/triploidy or hypoploidy in the G-banded karyotypes, the modal number in the G-banded karyotypes could not be elucidated with certainty with i-FISH. Three of the 10 MGUS patients showed abnormalities. In conclusion, PC-ID+ is important for the detection of structural aberrations and disclosing translocations involving 14q32. Of these, translocations t(4;14) constituted 9% and t(11;14), 20%. Finally, based on the small number of cytogenetically abnormal cases, it is recommended to include cytogenetics (and, for example, the DNA index) in the prognostic armamentarium.
Christensen
Jacob H
JH
Department of Hematology, Odense University Hospital, Winsloewparken 15/3, DK-5000 Odense C, Denmark.
Abildgaard
Niels
N
Plesner
Torben
T
Nibe
Anne
A
Nielsen
Ole
O
Sørensen
Anne G
AG
Kerndrup
Gitte B
GB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002869:Chromosome Aberrations; D002871:Chromosome Banding; D002880:Chromosomes, Human, Pair 11; D002882:Chromosomes, Human, Pair 13; D002883:Chromosomes, Human, Pair 14; D002886:Chromosomes, Human, Pair 17; D002894:Chromosomes, Human, Pair 4; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017404:In Situ Hybridization, Fluorescence / Q000379:methods*; D007399:Interphase; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000235:genetics / Q000473:pathology*; D009101:Multiple Myeloma / Q000235:genetics / Q000473:pathology*; D010950:Plasma Cells / Q000378:metabolism / Q000473:pathology*; D013997:Time Factors; D014178:Translocation, Genetic