title: The t(14;20) is a poor prognostic factor in myeloma but is associated with long-term stable disease in monoclonal gammopathies of undetermined significance.
abstract: A large series of plasma cell dyscrasias (n=2207) was examined for translocations which deregulate the MAF genes, t(14;20)(q32;q12) and t(14;16)(q32;q23), and their disease behavior was compared to a group characterized by the t(4;14)(p16;q32) where CCND2 is also up-regulated. The t(14;20) showed low prevalence in myeloma (27/1830, 1.5%) and smoldering myeloma (1/148, <1%) with a higher incidence in MGUS (9/193, 5% P=0.005). Strong associations with del(13) (76%), non-hyperdiploidy (83%) and gain of 1q (58%) were seen but no association with an IgA M-protein or absence of bone disease was noted. All three translocations were associated with poor outcome in myeloma, but strikingly all t(14;20) MGUS/smoldering myeloma cases (n=10) had stable, low level disease. In contrast, the 10 t(14;16) and 25 t(4;14) MGUS/smoldering myeloma cases were associated with both evolving and non-evolving disease. None of the associated genetic abnormalities helped to predict for progression from MGUS or smoldering myeloma.
authors.affiliation: LRF UKMF Cytogenetic Database, University of Southampton, Wessex Regional Genetics Laboratory, Salisbury, Wilts, UK. fiona.ross@salisbury.nhs.uk
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Ross
authors.forename: Laura
authors.initials: L
authors.lastname: Chiecchio
authors.forename: GianPaolo
authors.initials: G
authors.lastname: Dagrada
authors.forename: Rebecca K M
authors.initials: RK
authors.lastname: Protheroe
authors.forename: David M
authors.initials: DM
authors.lastname: Stockley
authors.forename: Christine J
authors.initials: CJ
authors.lastname: Harrison
authors.forename: Nicholas C P
authors.initials: NC
authors.lastname: Cross
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Szubert
authors.forename: Mark T
authors.initials: MT
authors.lastname: Drayson
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Morgan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000175:diagnosis / Q000235:genetics*; D009101:Multiple Myeloma / Q000175:diagnosis / Q000235:genetics*; D011379:Prognosis; D014178:Translocation, Genetic
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