Translocation t(11;14) and survival of patients with light chain (AL) amyloidosis.
BACKGROUND
Light chain amyloidosis is a rare plasma cell dyscrasia. Interphase fluorescence in situ hybridization (FISH) coupled to cytoplasmic staining of specific Ig (cIg-FISH) on bone marrow plasma cells has become well established in the initial evaluation of multiple myeloma, a related disorder. Little, however, is known about cytogenetic abnormalities in patients with light chain amyloidosis.


METHODS
We reviewed 56 patients with light chain amyloidosis who had cIg-FISH performed as part of their routine clinical testing using the standard screening panel employed in multiple myeloma at our institution.


RESULTS
Seventy percent of patients had abnormal cIg-FISH, with the most common abnormalities being IgH translocations [48%]--including t(11;14) [39%], and t(14;16) [2%]--and del13/del13q [30%]. No t(4;14) or deletions of 17p (p53) were observed. Patients with t(11;14) had the lowest levels of clonal plasma cells, and those with del13 had the highest. The risk of death for patients harboring the t(11;14) translocation was 2.1 (CI 1.04-6.4), which on multivariate analysis was independent of therapy.


CONCLUSIONS
Although preliminary, our data would suggest that cIg-FISH testing is important in patients with light chain amyloidosis and that t(11;14) is an adverse prognostic factor in these patients.
Bryce
Alan H
AH
Divison of Hematology, Mayo Clinic, 200 First Street, S.W., Rochester, MN 55905, USA.
Ketterling
Rhett P
RP
Gertz
Morie A
MA
Lacy
Martha
M
Knudson
Ryan A
RA
Zeldenrust
Steven
S
Kumar
Shaji
S
Hayman
Suzanne
S
Buadi
Francis
F
Kyle
Robert A
RA
Greipp
Philip R
PR
Lust
John A
JA
Russell
Stephen
S
Rajkumar
S Vincent
SV
Fonseca
Rafael
R
Dispenzieri
Angela
A
D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000235:genetics* / Q000473:pathology / Q000628:therapy; D002880:Chromosomes, Human, Pair 11 / Q000235:genetics*; D002883:Chromosomes, Human, Pair 14 / Q000235:genetics*; D005260:Female; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000235:genetics; D017404:In Situ Hybridization, Fluorescence / Q000379:methods / Q000706:statistics & numerical data; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D014178:Translocation, Genetic
D007147:Immunoglobulin Light Chains