title: The t(11;14)(q13;q32) translocation as a poor prognostic parameter for autologous stem cell transplantation in myeloma patients with extramedullary plasmacytoma.
abstract: BACKGROUND
  Fluorescence in-situ hybridization (FISH)-detected abnormalities, including del(17p), del(13q), and t(4;14), have been associated with inferior prognosis. However, there are few data about the prognostic significance of cytogenetic abnormalities for autologous stem cell transplantation (ASCT) in multiple myeloma (MM) patients with extramedullary plasmacytoma (EMP).
  
  
  METHODS
  Between April 2004 and December 2012, 290 MM patients underwent ASCT at 3 centers. FISH data for bone marrow samples obtained at diagnosis were available for 58 patients who had EMP at diagnosis or during treatment.
  
  
  RESULTS
  The t(11;14), t(4;14), del(13q), and 1q gain abnormalities were seen in 14.9%, 6.3%, 25.6%, and 42.9%, respectively. No t(14;16) or del(17p) cytogenetic abnormality was detected in the examined patients. Patients with t(11;14) had a lower response rate compared to patients with other cytogenetic abnormalities. EMP-specific relapse was higher in patients with t(11;14) than in patients with other cytogenetic abnormalities (42.9% vs. 10%-33.3%). Each of the 4 cytogenetic abnormalities predicted shorter median progression-free survival (6-12 months vs. 27-37 months) and shorter overall survival (16-22 months vs. 68 months or not reached) compared to no cytogenetic abnormality. The t(11;14) translocation was an important prognostic factor for both progression-free survival (hazard ratio, 25.154; P < .001) and overall survival (hazard ratio, 7.484; P = .024) in the multivariate analysis.
  
  
  CONCLUSIONS
  In the current study, t(11;14), t(4;14), del(13q), and 1q gain were associated with worse survival in MM patients with EMP. The role of t(11;14) as a prognostic parameter for ASCT in MM patients with EMP should be confirmed with a large, well-designed study.
authors: Division of Hematology-Oncology, Department of Internal Medicine, School of Medicine, Pusan National University, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors: Ho-Jin
authors: HJ
authors: Shin
authors: Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea. Electronic address: kihyunk@smc.samsung.co.kr.
authors: Kihyun
authors: K
authors: Kim
authors: Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun.
authors: Je-Jung
authors: JJ
authors: Lee
authors: Division of Hematology-Oncology, Department of Internal Medicine, School of Medicine, Pusan National University, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors: Moo-Kon
authors: MK
authors: Song
authors: Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, South Korea.
authors: Eun Yup
authors: EY
authors: Lee
authors: Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, South Korea.
authors: Sang Hyuk
authors: SH
authors: Park
authors: Department of Laboratory Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
authors: Sun-Hee
authors: SH
authors: Kim
authors: Department of Laboratory Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
authors: Mi-Ae
authors: MA
authors: Jang
authors: Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
authors: Seok Jin
authors: SJ
authors: Kim
authors: Division of Hematology-Oncology, Department of Internal Medicine, School of Medicine, Pusan National University, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors: Joo Seop
authors: JS
authors: Chung
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002880:Chromosomes, Human, Pair 11; D002883:Chromosomes, Human, Pair 14; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality* / Q000628:therapy; D010954:Plasmacytoma / Q000556:secondary*; D011379:Prognosis; D016019:Survival Analysis; D014178:Translocation, Genetic; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D016896:Treatment Outcome
keywords: Autologous stem cell transplantation; Cytogenetic abnormality; Fluorescence in-situ hybridization; Multiple myeloma; Plasmacytoma