Cytogenetics and Survival of Multiple Myeloma: Isolated and Combined Effects.
BACKGROUND
A variety of clinical and laboratory prognostic factors for multiple myeloma (MM) have been addressed in published studies. The prognostic significance of cytogenetic abnormalities is also under investigation.


METHODS
The present study evaluated the potential prognostic role of cytogenetic events and their combinations in terms of overall survival in a large cohort of unselected patients with MM (n = 432). Multivariate Cox regression analysis was performed, adjusting for age, gender, Chronic Kidney Disease Epidemiology Collaboration Kidney Disease: Improving Global Outcomes classification, International Staging System score, Eastern Cooperative Oncology Group performance status, serum lactate dehydrogenase, serum calcium, platelet count, and blood hemoglobin.


RESULTS
The presence of del(13q) (adjusted hazard ratio [HR], 1.71; 95% confidence interval [CI], 1.18-2.47), t(4;14) (adjusted HR, 2.00; 95% CI, 1.19-3.35), and/or del(17p) (adjusted HR, 2.03; 95% CI, 1.22-3.37) was independently associated with poorer overall survival. The poor prognosis seemed more pronounced among patients harboring combinations of 2 adverse cytogenetic abnormalities. In contrast, t(14;16), t(11;14), and add(1q21) were not associated with overall survival. The effect of bortezomib seemed rather minimal in the modification of the prognostic role mediated by del(17p).


CONCLUSIONS
The presence of del(13q), t(4;14), and del(17p), singly or in combination, seems to be an independent poor prognostic factor for patients with MM.
Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Theodoros N
TN
Sergentanis
Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Efstathios
E
Kastritis
Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Evangelos
E
Terpos
Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: mdimop@med.uoa.gr.
Meletios A
MA
Dimopoulos
Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Theodora
T
Psaltopoulou
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015415:Biomarkers; D002869:Chromosome Aberrations; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D053208:Kaplan-Meier Estimate; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality*; D009367:Neoplasm Staging; D011379:Prognosis; D014178:Translocation, Genetic; D016896:Treatment Outcome
D015415:Biomarkers
Bortezomib; del(13q); del(17p); t(14;16); t(4;14)