title: Deletion of the short arm of chromosome 1 (del 1p) is a strong predictor of poor outcome in myeloma patients undergoing an autotransplant.
abstract: Several chromosomal abnormalities detected by conventional cytogenetic analysis have an adverse impact on the outcome in myeloma patients. A wide spectrum of abnormalities involving chromosomes 1, 13, 14, and 17 has been described. We analyzed the outcome of 83 patients with clonal cytogenetic abnormalities, who underwent high-dose therapy and autologous stem cell transplantation for multiple myeloma at our institution. Clonal abnormalities were detected at diagnosis by conventional cytogenetic analysis in 83 patients. Patients underwent a single autologous transplant between April 2000 and May 2005. Preparative regimen was high-dose melphalan alone (73), or a combination of topotecan, melphalan, and cyclophosphamide (TMC=10). The most commonly observed chromosomal abnormalities were deletion of chromosome 13 (32%), hyperdiploidy (21%), deletion of chromosome 1p (18%), and t (11; 14) in 7% patients. Median follow-up among surviving patients was 25.5 months. Median interval from diagnosis to autotransplant was 7.7 months (range: 2.5-52). Median progression-free survival (PFS) for the entire group was 19 months and the median overall survival (OS) was 52 months. On univariate analysis, both PFS and OS were significantly shorter in patients with deletion 1p (P=.001 and <.0001, respectively). Thirty-two patients whose cytogenetic abnormalities returned to normal prior to autotransplant had longer PFS and OS than patients with persistent abnormalities (P=.02 and .08, respectively). Deletion 1p is associated with a significantly shorter remission and survival in patients undergoing high-dose therapy and a single autologous transplant for myeloma.
authors: Stem Cell Transplantation and Cellular Therapy, UT-M.D. Anderson Cancer Center, Houston, Texas 77030, USA. mqazilba@mdanderson.org
authors: Muzaffar H
authors: MH
authors: Qazilbash
authors: Rima M
authors: RM
authors: Saliba
authors: Bilal
authors: B
authors: Ahmed
authors: Gaurav
authors: G
authors: Parikh
authors: Floralyn
authors: F
authors: Mendoza
authors: Noman
authors: N
authors: Ashraf
authors: Chitra
authors: C
authors: Hosing
authors: Thuy
authors: T
authors: Flosser
authors: Donna M
authors: DM
authors: Weber
authors: Michael
authors: M
authors: Wang
authors: Daniel R
authors: DR
authors: Couriel
authors: Uday
authors: U
authors: Popat
authors: Partow
authors: P
authors: Kebriaei
authors: Amin M
authors: AM
authors: Alousi
authors: Paolo
authors: P
authors: Anderlini
authors: Rizwan C
authors: RC
authors: Naeem
authors: Richard E
authors: RE
authors: Champlin
authors: Sergio A
authors: SA
authors: Giralt
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002872:Chromosome Deletion; D002878:Chromosomes, Human, Pair 1; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality / Q000628:therapy*; D011237:Predictive Value of Tests; D011379:Prognosis; D014182:Transplantation, Autologous
chemical_list: D008558:Melphalan