title: Genomic aberrations and survival of patients with light-chain-only multiple myeloma undergoing autologous stem cell transplantation.
abstract: The majority of patients with multiple myeloma (MM) have intact immunoglobulin, but in a subset of patients (∼15%), their tumors produce monoclonal light chains only (LCO). Although specific genomic aberrations have emerged as a major prognostic factor in MM, their incidence and prognostic impact on LCO myeloma patients are not clear. We therefore investigated a cohort of 86 LCO MM cases diagnosed and treated with autologous stem cell transplantation at our institution. Overall, genomic risk factors del(13q), del(17p), t(4;14), 1p loss, and 1q21 gain were detected by cytoplasmic fluorescence in situ hybridization (cIg-FISH) in 40.6%, 18.5%, 11.9%, 18.8%, and 25% of the cases, respectively. Patients with del(13q) and 1q gains had a significantly shorter overall survival (OS) (median 80.4 vs 56.2 months, P = .021; median 77.9 vs 26.9 months, P = .006, respectively) and shorter progression-free survival (PFS) (median 33.4 vs 15.8 months, P = .002; median 33.4 vs 19.1 months, P = .011, respectively) than those without the genetic abnormalities. In addition, 1p loss was significantly associated with shorter PFS (median 37.9 vs 18.2 months, P = .001). There was no significant difference in PFS or OS in patients with or without t(4;14) or del(17p). On multivariate analysis, del(13q) was an independent prognostic factor for PFS and OS.
authors.affiliation: Department of Laboratory Haematology, Department of Medical Oncology and Haematology, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Nan
authors.initials: N
authors.lastname: Jiang
authors.forename: Connie
authors.initials: C
authors.lastname: Qi
authors.forename: Young
authors.initials: Y
authors.lastname: Trieu
authors.forename: Donna
authors.initials: D
authors.lastname: Reece
authors.forename: Hong
authors.initials: H
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D002869:Chromosome Aberrations; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000096:biosynthesis* / Q000235:genetics; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000235:genetics* / Q000276:immunology / Q000601:surgery*; D011379:Prognosis; D016019:Survival Analysis; D014182:Transplantation, Autologous
chemical_list: D007147:Immunoglobulin Light Chains