title: [Analysis of high-risk multiple myeloma patients treated with high-dose chemotherapy].
abstract: Although high-dose chemotherapy supported by autologous peripheral blood stem cell transplantation (auto-PBSCT) is the standard approach for younger patients with multiple myeloma, some of them still show a poor prognosis. We attempted to define a high-risk group among 32 patients who received auto-PBSCT between August 2000 and July 2007 in our hospital. In conventional metaphase cytogenetics (G-banding), chromosome abnormalities (CA), hypodiploidy, and 13 or 13q deletion (Gd13) were noted in 27.6, 17.2, and 19.4% of patients, respectively. In a FISH study, del(17p) (Fd17p) and t(4;14) were noted in 12.5 and 9.4% of patients, respectively. Prognostic analyses of patients with these abnormal chromosomes revealed that those with CA, hypodiploidy, Gd13, and t(4;14) showed a poorer survival at 3 years compared to those without them: 42.9 vs. 95.2% (p=0.0072), 25.0 vs. 91.5% (p=0.0056), and 40.0 vs. 91.8% (p=0.0245), 0 vs. 89.3% (p<.0001), respectively. When we defined patients showing at least one of CA, hypodiploidy, Gd13, Fd17p, and t(4;14) as a "high-risk group", they showed a poorer overall (23.9 vs. 106.1 mo., p=0.0011) and progression-free (13.5 vs. 25.6 mo., p=0.0095) survival compared to a non-high-risk group. This study indicated that chromosome analysis has a prognostic value in patients with multiple myeloma receiving auto-PBSCT.
authors.affiliation: Division of Hematology and Oncology, Toyohashi Municipal Hospital.
authors.forename: Shingo
authors.initials: S
authors.lastname: Kurahashi
authors.forename: Kotaro
authors.initials: K
authors.lastname: Suzuki
authors.forename: Akiyo
authors.initials: A
authors.lastname: Sawamoto
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Adachi
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Takumi
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Hiroto
authors.initials: H
authors.lastname: Narimatsu
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Hayakawa
authors.forename: Isamu
authors.initials: I
authors.lastname: Sugiura
mesh_terms: D001897:Boronic Acids / Q000008:administration & dosage; D000069286:Bortezomib; D002869:Chromosome Aberrations; D005260:Female; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000235:genetics* / Q000401:mortality / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D011379:Prognosis; D020551:Pulse Therapy, Drug; D011719:Pyrazines / Q000008:administration & dosage; D012306:Risk; D015996:Survival Rate; D013792:Thalidomide / Q000008:administration & dosage; D014182:Transplantation, Autologous
chemical_list: D001897:Boronic Acids; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib