title: Trisomies in multiple myeloma: impact on survival in patients with high-risk cytogenetics.
abstract: Routine incorporation of FISH into multiple myeloma (MM) diagnostic testing has led to a better appreciation of the heterogeneity of genetic abnormalities associated with this disease. We studied a group of 484 patients with newly diagnosed symptomatic MM to better understand the prevalence of the various abnormalities and the prognostic significance of the overlapping abnormalities. A translocation involving the IgH locus and 1 of the 5 recurrent partner chromosomes was seen in 161 (33%) patients, and 275 (57%) had trisomy of at least 1 odd-numbered chromosome. High-risk FISH, defined as the presence of t(4;14), t(14;16), t(14;20), or loss of P53, was seen in 115 (24%) patients; the median overall survival for this group was 3.9 years, compared with "not reached" for standard-risk patients (P < .001). Among the patients with high-risk FISH, 49 patients who also had at least 1 trisomy had a median overall survival that was not reached, compared with 3 years for high-risk patients without a concurrent trisomy (P = .01). Based on the current findings, we conclude that the presence of trisomies in patients with t(4;14), t(14;16), t(14;20), or p53 deletion abnormalities in MM ameliorates the usual adverse impact associated with these prognostic markers.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. kumar.shaji@mayo.edu.
authors.forename: Shaji
authors.initials: S
authors.lastname: Kumar
authors.forename: Rafael
authors.initials: R
authors.lastname: Fonseca
authors.forename: Rhett P
authors.initials: RP
authors.lastname: Ketterling
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.forename: Martha Q
authors.initials: MQ
authors.lastname: Lacy
authors.forename: Morie A
authors.initials: MA
authors.lastname: Gertz
authors.forename: Suzanne R
authors.initials: SR
authors.lastname: Hayman
authors.forename: Francis K
authors.initials: FK
authors.lastname: Buadi
authors.forename: David
authors.initials: D
authors.lastname: Dingli
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Knudson
authors.forename: Alexandra
authors.initials: A
authors.lastname: Greenberg
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Russell
authors.forename: Steven R
authors.initials: SR
authors.lastname: Zeldenrust
authors.forename: John A
authors.initials: JA
authors.lastname: Lust
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kyle
authors.forename: Leif
authors.initials: L
authors.lastname: Bergsagel
authors.forename: S Vincent
authors.initials: SV
authors.lastname: Rajkumar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000235:genetics* / Q000401:mortality*; D011379:Prognosis; D012306:Risk; D016019:Survival Analysis; D014178:Translocation, Genetic; D014314:Trisomy; D055815:Young Adult