title: Gender disparities in the tumor genetics and clinical outcome of multiple myeloma.
abstract: BACKGROUND
  Several cancer types have differences in incidence and clinical outcome dependent on gender, but these are not well described in myeloma. The aim of this study was to characterize gender disparities in myeloma.
  
  
  METHODS
  We investigated the association of gender with the prevalence of tumor genetic lesions and the clinical outcome of 1,960 patients enrolled in the phase III clinical trial MRC Myeloma IX. Genetic lesions were characterized by FISH.
  
  
  RESULTS
  Disparities were found in the prevalence of primary genetic lesions with immunoglobulin heavy chain gene (IGH) translocations being more common in women (50% of female patients vs. 38% of male patients, P < 0.001) and hyperdiploidy being more common in men (50% female vs. 62% male, P < 0.001). There were also differences in secondary genetic events with del(13q) (52% female vs. 41% male, P < 0.001) and +1q (43% female vs. 36% male, P = 0.042) being found more frequently in female myeloma patients. Female gender was associated with inferior overall survival (median: 44.8 months female vs. 49.9 months male, P = 0.020).
  
  
  CONCLUSIONS
  We found gender-dependent differences in the prevalence of the primary genetic events of myeloma, with IGH translocations being more common in women and hyperdiploidy more common in men. This genetic background may impact subsequent genetic events such as +1q and del(13q), which were both more frequent in women. The higher prevalence of lesions associated with poor prognosis in the female myeloma population, such as t(4;14), t(14;16) and +1q, may adversely affect clinical outcome.
  
  
  CONCLUSIONS
  These differences suggest that gender influences the primary genetic events of myeloma.
authors.affiliation: The Institute of Cancer Research, Section of Haemato-Oncology, London, United Kingdom.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Boyd
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: Zoe J
authors.initials: ZJ
authors.lastname: Konn
authors.forename: William J
authors.initials: WJ
authors.lastname: Tapper
authors.forename: Brian A
authors.initials: BA
authors.lastname: Walker
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Wardell
authors.forename: Walter M
authors.initials: WM
authors.lastname: Gregory
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Szubert
authors.forename: Faith E
authors.initials: FE
authors.lastname: Davies
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Morgan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002869:Chromosome Aberrations / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics*; D015995:Prevalence; D012737:Sex Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D007143:Immunoglobulin Heavy Chains