Heterogeneity of t(4;14) in multiple myeloma. Long-term follow-up of 100 cases treated with tandem transplantation in IFM99 trials.
One hundred de novo multiple myeloma patients with t(4;14) treated with double intensive therapy according to IFM99 protocols were retrospectively analyzed. The median overall survival (OS) and event-free survival (EFS) were 41.4 and 21 months, respectively, as compared to 65 and 37 for patients included in the IFM99 trials without t(4;14) (P<10(-7)). We identified a subgroup of patients presenting at diagnosis with both low beta(2)-microglobulin <4 mg/l and high hemoglobin (Hb) >/=10 g/l (46% of the cases) with a median OS of 54.6 months and a median EFS of 26 months, respectively, which benefits from high-dose therapy (HDT); conversely patients with one or both adverse prognostic factor (high beta(2)-microglobulin and/or low Hb) had a poor outcome. The achievement of either complete response or very good partial response after HDT was also a powerful independent prognostic factor for both OS and EFS.
Moreau
P
P
Hematology Department, University Hospital, Nantes, France.
Attal
M
M
Garban
F
F
Hulin
C
C
Facon
T
T
Marit
G
G
Michallet
M
M
Doyen
C
C
Leyvraz
S
S
Mohty
M
M
Wetterwald
M
M
Mathiot
C
C
Caillot
D
D
Berthou
C
C
Benboubker
L
L
Garderet
L
L
Chaleteix
C
C
Traullé
C
C
Fuzibet
J G
JG
Jaubert
J
J
Lamy
T
T
Casassus
P
P
Dib
M
M
Kolb
B
B
Dorvaux
V
V
Grosbois
B
B
Yakoub-Agha
I
I
Harousseau
J L
JL
Avet-Loiseau
H
H
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002883:Chromosomes, Human, Pair 14; D002894:Chromosomes, Human, Pair 4; D003561:Cytarabine / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018740:Genetic Heterogeneity; D006454:Hemoglobins; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000235:genetics* / Q000401:mortality; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D014178:Translocation, Genetic; D014750:Vincristine / Q000008:administration & dosage; D001613:beta 2-Microglobulin / Q000097:blood
D006454:Hemoglobins; D001613:beta 2-Microglobulin; D003561:Cytarabine; D014750:Vincristine; D003907:Dexamethasone