title: Baseline characteristics, chromosomal alterations, and treatment affecting prognosis of deletion 17p in newly diagnosed myeloma.
abstract: Deletion 17p13, del(17p), is associated with poor outcome in myeloma but some patients show long-term survival. With the current study we intended to identify factors impacting outcome of such high risk patients. We analyzed 110 newly diagnosed, symptomatic patients with del(17p) detected by fluorescence in situ hybridization (FISH) in CD138-purified myeloma cells to identify prognostic factors for survival. Age >65 years, ISS III, and elevated LDH negatively impacted survival. Patients with subclonal (10-60% of plasma cells) del(17p) had longer progression-free survival (PFS) than patients with del(17p) in >60% of plasma cells (26 vs. 19 months, P = 0.03). Additional gain of 1q21 was associated with shorter PFS (17 vs. 25 months, P = 0.01). Hyperdiploidy did not ameliorate impact of del(17p), but gain 19q13 predicted longer PFS (30 vs. 18 months, P = 0.01) and overall survival (50 vs. 29 months, P = 0.01). Multivariate analysis in transplant eligible patients (≤65 years) revealed better survival for patients treated with upfront autologous transplantation (hazard ratio, [95% confidence interval]: 0.15 [0.04, 0.58], P = 0.006). Application of maintenance therapy was associated with better survival in transplant-eligible patients (0.30 [0.09, 0.99], P = 0.05). We demonstrate heterogeneous outcome of patients with del(17p) according to baseline characteristics and treatment. 19q13 should be included in routine FISH panel, since gains were associated with better survival. Am. J. Hematol. 91:E473-E477, 2016. © 2016 Wiley Periodicals, Inc.
authors: Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany. maximilian.merz@med.uni-heidelberg.de.
authors: Maximilian
authors: M
authors: Merz
authors: Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors: Thomas
authors: T
authors: Hielscher
authors: Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany.
authors: Anja
authors: A
authors: Seckinger
authors: Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany.
authors: Dirk
authors: D
authors: Hose
authors: Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany.
authors: Elias K
authors: http://orcid.org/0000-0002-6226-1252
authors: EK
authors: Mai
authors: Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany.|Max-Eder Research Group Experimental therapies for hematologic malignancies, DKFZ, Heidelberg, Germany.
authors: Marc S
authors: MS
authors: Raab
authors: Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany.|National Center for Tumor Diseases (NCT), Heidelberg, Germany.
authors: Hartmut
authors: H
authors: Goldschmidt
authors: Institute of Human Genetics, University Heidelberg, Heidelberg, Germany.
authors: Anna
authors: A
authors: Jauch
authors: Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany.|Department of Radiology, German Cancer Research Center DKFZ, Heidelberg, Germany.
authors: Jens
authors: J
authors: Hillengass
mesh_terms: D000368:Aged; D002869:Chromosome Aberrations; D002872:Chromosome Deletion; D002878:Chromosomes, Human, Pair 1 / Q000235:genetics; D002886:Chromosomes, Human, Pair 17; D002888:Chromosomes, Human, Pair 19 / Q000235:genetics; D018572:Disease-Free Survival; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D058496:Smith-Magenis Syndrome / Q000401:mortality*; D033581:Stem Cell Transplantation / Q000379:methods / Q000401:mortality; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome