Cytogenetics of extramedullary manifestations in multiple myeloma.
Extramedullary disease in patients with multiple myeloma is a rare event, occurring mostly in advanced disease or relapse. Outcome is poor and prognostic factors predicting the development of extramedullary disease have not been defined. We investigated cytogenetic alterations of myeloma cells in different extramedullary manifestations by adapting the fluorescence in situ hybridization (FISH) technique in combination with cytoplasmic immunoglobulin staining to study the cytogenetics of plasma cell tumours on paraffin embedded material. Thirty six patients were investigated: 19 with extramedullary disease, 11 with skeletal extramedullary disease and six with solitary extramedullary plasmacytoma. The first two groups showed the following results: del(17p13) 32% vs. 27%, del(13q14) 35% vs. 27%, MYC-overrepresentation 28% vs. 18% and t(4;14) 37% vs. 18%. We detected an overall higher incidence of del(17p13) in both groups compared to data from bone marrow samples of multiple myeloma reported to date (range 7-16%). The solitary extramedullary plasmacytomas presented overall less cytogenetic aberrations than the other groups. Most important, three patients with extramedullary disease and one with skeletal extramedullary disease presented different FISH findings in the extramedullary tumour compared to their bone marrow plasma cells. del(17p13), occurring additional in three of four cases, seems a strong marker for extramedullary progression of myeloma.
Department of Oncology, Haematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Cancer Centre, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Lisa
L
Billecke
Eva M
EM
Murga Penas
Annette M
AM
May
Monika
M
Engelhardt
Arnon
A
Nagler
Merav
M
Leiba
Ginette
G
Schiby
Nicolaus
N
Kröger
Jozef
J
Zustin
Andreas
A
Marx
Jakob
J
Matschke
Markus
M
Tiemann
Eray
E
Goekkurt
Hans-Heinrich
HH
Heidtmann
Eik
E
Vettorazzi
Judith
J
Dierlamm
Carsten
C
Bokemeyer
Georgia
G
Schilling
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002869:Chromosome Aberrations; D002872:Chromosome Deletion; D002886:Chromosomes, Human, Pair 17 / Q000235:genetics; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000235:genetics* / Q000473:pathology / Q000628:therapy; D010954:Plasmacytoma / Q000235:genetics / Q000473:pathology; D012189:Retrospective Studies; D055815:Young Adult