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.
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.
Ross
Fiona M
FM
LRF UKMF Cytogenetic Database, University of Southampton, Wessex Regional Genetics Laboratory, Salisbury, Wilts, UK. fiona.ross@salisbury.nhs.uk
Chiecchio
Laura
L
Dagrada
GianPaolo
G
Protheroe
Rebecca K M
RK
Stockley
David M
DM
Harrison
Christine J
CJ
Cross
Nicholas C P
NC
Szubert
Alex J
AJ
Drayson
Mark T
MT
Morgan
Gareth J
GJ
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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